Back Pain

Back pain, most commonly of the lower spine, affects 4 out of 5 people at some stage of their life.

Back pain can start suddenly after reaching or twisting or come on slowly over a few days or weeks.

Short term (acute) back pain is often caused by simple muscle strains or spasms. It usually lasts less than 3 months, and then normal function returns.

Long term (chronic) back pain tends to develop over time and last more than 3 months. This is less likely to be linked to tissue damage or injury and may be as a result of a more long-term spine condition.

Causes of back pain

There are many causes of lower back pain. These include structural misalignment, hereditary disorders, disc degeneration in the spine, nerve damage, muscle imbalance and dysfunction of the lower back/pelvic region caused by poor timing or function of the feet and legs when walking. Very often it is a combination of a number of these factors and that’s why if only one area is treated the condition improves but does not completely resolve.


See a doctor immediately if you have any weakness in your lower legs, develop any bowel or bladder problems (such as incontinence) or numbness over your buttocks and anal region.

Abnormal foot function and back pain

If your foot works in an excessively rolled in position, especially as it lifts off the ground, it causes the leg to remain in an internally rotated position, resulting in a forward tilt of the pelvis which in turn increases the curvature of the spine and places strain on the muscles and ligaments of the lower back.

Poor foot function due to leg length difference

Most people have a slight difference in the length of each leg but if this becomes marked through dysfunction of the pelvis or injury and sometimes surgery, (for example hip surgery), it will force the foot to compensate. Usually this causes one foot to function rolled-in and the other to function in a rolled-out position. This places strain on the foot, leg and pelvis and may result in a pelvic tilt and twisting of the spine, placing strain on the associated muscle and ligaments.

Management of back pain

The first step to managing back pain is to get a good diagnosis and management plan. Seek help from your doctor, physiotherapist or other suitably qualified medical professional.

They will:

  • Assess your back and pinpoint where any problem areas may be.
  • Identify any function or restriction that may be adding to your pain.
  • Provide you with exercises and advice to reduce pain and prevent further episodes.

In cases where the way your foot and leg works is impacting lower back pain, a podiatrist can work with the health professional team to assess mechanics and function from the ground up and offer solutions.

The podiatrist will ascertain what dysfunction is occurring in your feet, how this may be interacting with the muscles in your back, pelvis and legs and will see what areas in your lifestyle may be placing you at risk of continuing the injury; Eg: sport, posture and even footwear.

What we do every day is important to help keep backs strong and flexible

Three tips for healthy backs:
  1. Keep active – undertake regular exercise such as walking, or swimming.
  2. Maintain good posture – sit and stand up straight. Review how you sit, relax and stand.
  3. Take extra care with lifting – bend your knees, keep your head up, back straight, ensure your core muscles are engaged when lifting and be sensible about what you lift.

For recurring back pain, the following may help:

  • Exercise regularly - people who do regular exercise have less back pain than those who are inactive.
  • Lose weight - the more overweight someone is, the more strain this put on all their joints, muscles and back.
  • Avoid activities that cause sudden movements and muscle strain.
  • Review your footwear - flat shoes with good arch support and cushioning can help.
  • Manage stress and anxiety -anxiety and stress can all increase muscle tension and back pain.

Formthotics can help relieve the symptoms of lower back pain

Where foot function or a leg length discrepancy is impacting your back, orthotics can be used to assist and significantly improve the foot and leg function, which in turn can improve back pain.

Formthotics support the structures of the foot to encourage optimal function and even pressure distribution. In doing this they reduce fatigue, increase shock absorption and reduce pain.

The multiple options available allow your podiatrist or medical professional to select Formthotics best for your feet, footwear and activity. Your Formthotics are then able to be customised by your clinician specifically for your needs.

Formthotics dual density products add a cushioning layer on top of the supportive structure of Formthotics. The Formax™ dual density foam provides increased shock absorption and even pressure distribution while maintaining a good level of support to optimise foot function and general comfort.

For further information