A systematic review: the effects of podiatrical deviations on nonspecific chronic low back pain

• Published in: Journal of back and musculoskeletal rehabilitation 2013-01, Vol.26 (2), p.117-123
• Main Authors: O'Leary, Colin B, Cahill, Caroline R, Robinson, Andrew W, Barnes, Meredith J, Hong, Junggi
• Format: Article
• Language: English
• Subjects: Ankle Joint; Biomechanical Phenomena; Chronic Pain; Flatfoot - complications; Flatfoot - physiopathology; Foot Deformities - complications; Foot Deformities - physiopathology; Foot Deformities - rehabilitation; Gait; Hallux Valgus - complications; Hallux Valgus - physiopathology; Humans; Joint Instability - complications; Joint Instability - physiopathology; Joint Instability - rehabilitation; Leg Length Inequality - complications; Leg Length Inequality - physiopathology; Leg Length Inequality - rehabilitation; Low Back Pain - etiology; Low Back Pain - physiopathology; Low Back Pain - rehabilitation; Orthotic Devices; Postural Balance; Pronation
• ISSN: 1053-8127; 1878-6324
• DOI: 10.3233/BMR-130367

Lower back pain (LBP) is a widespread, expensive, and debilitating problem in Western industrialized countries. Though LBP can be caused by acute injuries, biomechanical discrepancies have also been indicated to cause chronic LBP. A possible link between podiatrical deviations and LBP has been established in the literature; yet, no comprehensive review investigating the effects of foot and ankle deviations on low back pain has been published. The aim of this study was to assess the relevant literature concerning the effects of foot and ankle deviations on LBP. After review, it was determined that there is limited research regarding ankle and foot deviations and their connection to LBP. Reviewed studies have linked flat feet, ankle instability, sagittal plane blockage and excessive pronation to LBP. Specifically, excessive pronation has been shown to cause leg length discrepancies leading to pelvic tilts and LBP. Based on these results, ankle and foot deviations can be considered a potential cause for LBP due to the disruption of the kinetic chain from the foot to the back. Clinicians should consider the foot and ankle when addressing LBP, especially if more conventional etiologies fail to describe the condition.