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  • Q&A with Australian Health Practitioners

    Can a flat foot cause severe lower back pain?

    I've had flat foot since childhood and used to wear orthotics but haven't done so for years now. Recently I started having lower back tightness which I can't explain the cause - no injury or past conditions affecting the back. Just wondering if it's related to my flat feet and if I have to wear orthotics again how can I wear them in work shoes/sandals? Thanks.
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  • 35


    low force chiropractor for 27 years experienced in SOT AK diversified activator proficient and Neural organizaiton techniqu proficient. seminars given in perth auckland and sydney … View Profile

    We rarely have one leg or foot the same size this due to pelvic and postural in balance . Yes flat feet can affect the low back as the nerve supply to the large toe and little toes come down from the sacrum and lumbar nerves. if the facia plantaris is slackend and the feet bones splay out this will disturb the gait mechanism and result in other muscles compensating as you walk. the quadratus lumborum muscles and the psoas muscles which are hip flexors will become reactive and begin to compensate for the abnormal neural input into the vestibular propriocetive spinal tracts. Lordosis and or scoliosis can exist. Orthotics will help once you are reorganized neurologically via neural organization technique or sacro occipital technique and Applied Kinesiology…. there are sandals these days with built in orthotics and foot levellers are excellent for your shoes and boots.

  • 16


    Dr Adam Arnold

    Chiropractor, Hypnotherapist

    Dr. Adam Arnold received his chiropractic degree from Cleveland Chiropractic College in Kansas City MO in 1996. Dr. Arnold has been practising as a chiropractor … View Profile

    Adding to Dr. Clark's answer, I would be curious when you are getting the low back pain?  If the stiffness occurs after walking, then I would think flat feet could be a contributing cause.  If you are sitting for work during the day, the stiffness could be coming from a lack of motion and tightening of your hamstrings.  If you wake up with the stiffness, this could be due to faulty sleeping positions.  A thorough history with a chiropractor or other qualified health care professional would be able to point you into the right direction if orthotics are necessary or other causes.  

  • 10


    Kevin Shapiro


    17 years experience in Australia, South Africa and the United Kingdom in private practice. I specialize in the treatment of back and neck pain as … View Profile

    Yes, pronated/flat feet will cause biomechanical compensatory lower back pain. I would recommend antipronation orthotics or supportive shoes or sandals.

  • 13


    Anthony Short

    Podiatrist (General)

    Anthony Short BAppSc(Pod) MPod hold both Bachelor and Master level degrees in podiatry, and works in private practice, hospital and educational positions within Brisbane. His … View Profile

    There is a growing body of evidence to support what podiatrists have long observed and suspected regarding the relationship between flat foot (pes plano valgus) and lower back pain.
    If there are significant postural asymmetries caused by unilateral flat foot (for example, in posterior tibial tendon dysfunction), then this can have deleterious effects of the movement of the entire lower limb and pelvis, and even induce a functional leg length difference.
    A comprehensive physical and gait examination by a podiatrist experienced in biomechanical and postural musculoskeletal problems can confirm if there is a link and recommend treatment such as orthotics to address this pain if it is of a mechanical nature.

  • 10


    Dr Adam Wild


    I studied at Macquarie University completing both Bachelor and Master degree's. While there I was the Vice President of MUCSA (Macquarie University Chiropractic Students Association) … View Profile

    Biomechanical changes in the foot can have detrimental effects along the whole leg and lower limb into pelvis and into the low back. Usually, these can cause pain or symptoms elsewhere, rather than just the foot, such as knee pain, hip pain, low back pain, foot pain.
    Could I just add it would be wise to find a practitioner that would look at all of these elements, rather than just the low back or just the foot, such as a chiropractor.

  • 9


    Jacqueline Kan

    Podiatrist (General)

    Cheltenham Podiatry offers excellence in all areas of footcare.From corns, callouses, fungal nails to sports injuries, Diabetic foot care, ingrown nails and orthotics. Full gait … View Profile

    Hi, from my experience orthotics can help some lower back complaints. I would suggest you get your back checked out first by a back specialist, chiropractor or physiotherapist to rule out back related causes of your pain. But, if this fails then definately there is a strong possibilty your inefficient mechanics of your feet and legs may be a strong or part contributer to your pain. I would advise then you see a podiatrist. In regards to the shoe fitting issues, once you have your orthotics you will need  to possibly get new shoes, as it it is likely your shoe size will increase. So ,you would then take the new orthotics with you to the shoe shop and fit them with the new shoes. Orthotics usually require deeper heel counters, an adjustment(laces, velcro or buckles) to help the fit ,this   provides better support and effectiveness of the orthotic. The sandel situation is always difficult but these days there are alot more speciality shoes available, you will need a sandel with a firm  deep heel counter and velcro straps, or other adjustment at the top.Here speciality shoe shops will be the only ones with this type of sandel. In melbourne Extra depth are good for these. You will usually have no problem putting orthotics in runners. Your podiatrist will advise on specific shoe requirements when they issue the orthotic. Good luck

  • Brett Rawlings

    Acupuncturist, Myotherapist

    I’m an Acupuncturist, Credentialed McKenzie Method Therapist and Clinical Myotherapist with 20 years clinical experience treating musculoskeletal pain and dysfunction.10 years ago I made the … View Profile

    I think Adam has raised an important diagnostic point. If you experience pain sitting, it’s highly unlikely to be your flat feet that are the issue. Most patients who have lower back pain, like yourself, can't identify an incident leading to its onset because it's typically due to the cumulative effect of poor posture. Regards,Brett Rawlings

  • 1




    Dr Andrew Knox

    Podiatric Surgeon, Podiatrist (General)

    Dr. Andrew Knox is one of the most-highly qualified foot specialists in Australia, holding both a Bachelor of Podiatric Medicine and a Doctorate of Clinical … View Profile

    We performed a prospective study 2 years ago to look at the relationship between having flat feet and lower back pain and found them to be associated. There are varying degrees of literature which would support this theory also. Best to have your back assessed by a practitioner who specialises in this area, such as a chiropractor and get your feet assessed by a podiatrist also. Kind regards

  • 2


    Lisa Farrant

    Podiatrist (General)

    Diabetic foot assessments. Surgical management of ingrown toenails. Specialized clinical experiece in ulcer management & High Risk feet. Lower limb vascular assessments. Biomechancial assessments and … View Profile

    Flat feet can certainly be the cause of ongoing back pain. As the arches of our feet are an integral part in absorbing the forces that translate up through our feet with every  step we take, to our knees, hips and spine, having some arch is important. Flat feet that are left untreated can therefore increase the stress to these other joints in our lower body, and in our later lives, lead to osteoarthritis changes.

    Likewise, someone who suffers from lower lumbar issues may suffer from foot pain, due to the nerves in our lower spine being compromised (ie: disc buldge,protusion or prolapse causing a nerve to be compressed), and therefore we can suffer from referred pain down this nerve to the feet, as we see with people with sciatica symptoms.

    I would recommend seeing a podiatrist for your flat feet (Pes Plano Valgus), and a chiropractor or physiotherapist or other specialist practitioner for you lumbar pain issues. Sometimes when our body has been trying to compensate for malalignments, and you are corrected with orthoses, you may also require adjustments further up the body by a chiropractor or the like.

    I hope you are feeling better soon.

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