Treating Chronic Low Back Pain with Orthotic Devices in Patients with Flat Feet
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This article, only in abstract form, makes the excellent correlation between chronic low back pain and pes planus.The treatment with foot orthotic devices showed excellent relief of pain and functional improvement in low back pain sufferers. In my practice, I gradually got referrals from back specialists for the use of orthotic devices in their patients. However, most of the time, it is the low back sufferer that comments how better they feel in the low back even though the reason for giving the orthotic device from you was related to a foot or ankle problem. I always recommend when a patient is being evaluated for custom orthotic devices, always ask what symptoms from head to toe are they having at that time. Once the orthoses are dispensed at the 1 or 3 month followup visit, ask about the effect of the orthotics on all their complaints. You will get a good understanding over time of how functional foot orthotic devices affect spinal issues, upper extremity issues, hip and knee issues,etc. I will always remember the very first patient in private practice1981 who I had designed custom orthoses for his runner’s knee complaints. At the one month followup, when asked about his knee, he told me two things. First of all, the orthotic devices were helping 10-20% of his knee pain (couldn’t run, but walked without pain now). Then, secondly, he said with a big smile on his face that 10 years of chronic left shoulder pain was gone since using the foot orthoses. This remains true at his year followup, and then I lost contact with him.
Even though the article focuses on the treatment of flat feet and low back pain, other causes of low back pain that you can help with are:
- Recognition and treatment of limb length discrepancy
- Recognition and treatment of tight hamstrings
- Recognition and treatment of poor shock absorption patients
- Recognition of patients that underpronate or supinate in contact phase.
- Inability or delay of smoothly rolling through your foot in the sagittal plane (Dr. Dananberg’s concepts)
This gives you six avenues to use to help millions of patients with chronic low back pain.
