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Low Back Pain

Symptoms:

The patient will present with pain and stiffness in the lumbar region, espically after standing for long periods of time.

Causes:

There are a number of causes for low back pain. In many patients excessive foot pronation may contribute to lower back problems. Bilateral excess pronation causes internal rotation of the tibia which in turn leads to anterior tilt of the pelvis and a forward shift of the body's center of gravity.

The result is increased lordotic curvature increased lordosis at L1-L5 and compensatory muscular tightness of the lumbo-sacral region, causing pain and discomfort especially when standing upright for longer periods of time. The thoracic region commonly develops a secondary kyphotic curvature. 

Unilateral pronation lowers the vertical distance of the foot to the ground, therefore creating a functional short leg, causing hip mal-alignment. Structural leg length discrepancy means that one leg is actually shorter than the other. In this case the patient will often present with unilateral pronation (i.e. worse on one foot) as a natural compensation for the structural imbalance.

Both functional and structural leg length discrepancy can cause back pain. Patients presenting with a leg length discrepancy often also exhibit Scoliosis. 

Treatment:

Back pain can be treated with stretching and strengthening exercises, manipulation, spinal adjustments, soft tissue massage therapy etc. Adding orthotic therapy to your treatment regime can be beneficial. Correcting excessive pronation with Footlogics orthotics will assist by posteriorly rotating the pelvis, thus reducing pressure on the sacro-iliac area. 

Patients with a structural leg length discrepancy will require Footlogics orthotics for both feet to firstly correct the excess pronation. Next a Heel Lift should be added to the orthotic on the shorter leg. By doing so the shorter leg will be raised, aiding in rebalancing the lower limb and removing compensatory mechanisms that may contribute to low back pain. 

In case of a functional leg length difference Footlogics orthotics should be prescribed (both feet), however a heel lift should not be applied to the shorter side.