Back Pain and Footwear: A Connection You Can’t Ignore

Reviewed by Dr. Darshit Patel, MD, General Medicine

Back pain is one of the most common health complaints globally, affecting people of all ages, from schoolchildren to older adults. While injuries, poor posture, and sedentary lifestyles are frequently mentioned as culprits, one critical yet often overlooked factor is footwear. Daily shoes can support the spine’s natural alignment or silently contribute to chronic pain.

The Foundation of Spinal Health

Our feet form the foundation of the entire musculoskeletal system. Every time we stand, walk, or run, our feet bear the body’s full weight, absorbing and distributing forces evenly. Footwear that fails to support this natural mechanism can create a chain reaction of imbalances, affecting the ankles, knees, hips, and ultimately the spine.

Poor Footwear Choices and Their Side Effects

• Flat shoes without arch support, like flip-flops or worn-out sneakers, often lead to overpronation, when the foot rolls inward excessively. This misalignment can strain the knees and hips, placing abnormal stress on the lower back.

• High-heeled shoes shift the body’s centre of gravity, causing the wearer to lean unnaturally forward or backwards. This results in increased spinal compression and muscle strain in the lower back. Long-term use can even shorten calf muscles and the Achilles tendon, leading to postural imbalances.

Improper cushioning in shoes is another risk. Hard soles transmit impact directly to the spine, while overly soft soles can compromise stability, making it harder to maintain balance.

Dr. Vidya Chilvery (PT) of MedBound Times connected with Dr. Vruti Mehta (PT, CMP, MIAP), a physiotherapist with over 12 years of experience treating musculoskeletal conditions, for her insights. She said:

Choosing Footwear That Supports Spinal Health

To prevent or reduce back pain, it’s important to select footwear with the following features:

• Arch Support: Maintains the foot’s natural curve and distributes body weight evenly.

• Cushioning: Absorbs shock, reducing joint and spinal stress.

• Heel Height: A small, stable heel (around 1 inch) promotes natural posture better than flat soles.

• Proper Fit: Ill-fitting shoes alter gait mechanics and impact spinal alignment.

For those with unique foot structures such as flat feet, high arches, or bunions, custom orthotic inserts can offer targeted support and help correct imbalances before they affect the back.

When to Seek Help

If you experience unexplained back pain, especially after standing or walking for extended periods, your footwear might be a contributing factor. A physiotherapist or podiatrist can evaluate your posture and gait to identify any underlying issues.

A Deeper Connection

Footwear isn’t just about style or comfort—it’s essential to maintaining musculoskeletal health. The next time you shop for shoes, consider how your choice may impact your spine.

“Your spine reflects the story your feet are trying to tell—listen closely, and you’ll walk a pain-free path.”

Choosing the right footwear is a simple yet effective step toward better spinal health. By making informed choices today, you could reduce the need for future doctor’s visits, minimize medication use, and enjoy more pain-free days. It all begins at ground level—literally.

By Dr. Vidya Chilvery (PT)

MSM/DP