Foot Orthotics

The Link Between Footwear and Back Pain: How to Find Relief


Footwear can cause lower back pain and problems for some individuals. Can understanding the connection between footwear and back problems help individuals find the right shoes to maintain back health and relieve pain?

Footwear Back Pain

The back provides the strength for physical activities. Back pain affects daily life and can have various causes. Unhealthy posture, walking, twisting, turning, bending, and reaching can contribute to back problems that result in pain. According to the CDC, 39% of adults report living with back pain (Centers for Disease Control and Prevention, 2019). Improper footwear can also contribute to back pain. Selecting footwear carefully can help bring pain relief and help maintain spinal health. Individuals can enjoy less pain and manage symptoms by choosing shoes that maintain spinal alignment and protect the feet from blunt impact.

Understanding the Back Pain-Footwear Connection

Improper footwear could be the cause of lower back pain. What impacts the bones at the bottom of the neuromusculoskeletal system radiates upward and affects the spine and back muscles. What footwear is used travels upward, impacting gait, posture, spinal alignment, and more. When back problems originate from the feet, these are biomechanical issues. Biomechanics means how the bones, joints, and muscles work together and how changes in external forces impact the body.


When the feet impact the ground, they are the first extremities to absorb shock for the rest of the body. Individuals will start to walk differently if they have a problem or change in their feet. Wearing shoes with improper support can increase the wear and tear on the muscles and joints, leading to awkward and unnatural movement. For example, consider the difference between standing on tiptoes in high heels and the natural flat-footed state. Well-cushioned shoes help absorb impact and lessen pain sensations. The pressures on each of the joints shift balance, which causes instability problems with less pressure on some and more on others. This creates an imbalance that leads to pain and joint conditions.


Maintaining a healthy posture is another factor in preventing or alleviating back pain. With the right footwear, the body can maintain a healthier stance and the right curvature throughout the spine, and it helps distribute the weight evenly. This results in decreased stress on ligaments, muscles, and joints. (Harvard Health Publishing. 2014) It’s recommended to see an orthopedist to get to the root of an individual’s condition. For some, a herniated disc, sciatica, automobile collision, fall, unhealthy ergonomics, or a combination, as well as other underlying issues, may be contributing to their back pain.

Shoe Types and Their Impact on The Back

How various shoes impact posture, potentially causing or relieving back pain.

High Heels

High heels can definitely contribute to back pain. They change body posture, causing a domino effect on the spine. The body’s weight is shifted to increase pressure on the balls of the feet, and the spine’s alignment becomes altered. High heels also affect how the ankles, knees, and hips move when walking, balance, and how the back muscles operate, all of which can worsen back pain.

Flat Shoes

Flat shoes may not be the best choice for spinal health. If they lack arch support, they can cause the foot to roll inward, known as pronation. This can contribute to misalignment, which can strain the knees, hips, and lower back. However, they can be a decent choice if they provide arch support. When wearing flat shoes with healthy support, the weight is distributed evenly on the feet and the spine. This helps maintain correct posture, which can help prevent and/or alleviate back pain.

Sneakers, Tennis, and Athletic Shoes

Sneakers, tennis, and athletic shoes can relieve back pain with thorough cushioning and support. Choosing the right ones involves determining the activity that will be done in them. There are tennis, running, basketball, pickleball, skating shoes, and more. Research what features will be needed for the sport or activity. This could include:

  • Heel cups
  • Insole cushioning
  • Wide base
  • Other features to meet individual foot needs.

It is recommended that athletic shoes be changed every 300 to 500 miles of walking or running or with any signs of unevenness when placed on a flat surface, as worn-out soles and degraded materials can increase the risk of injury and back pain. (American Academy of Podiatric Sports Medicine, 2024).  If a certain pair puts the legs, hips, or ankles into an unnatural position or impedes regular movement, it may be time to replace them.

Choosing the Right Shoes

The ideal solution for choosing shoe wear is to get a gait analysis and a review of how you walk and run. Various healthcare professionals may offer this service to tailor each individual’s search for the right shoes for back pain. In gait analysis, individuals are asked to run and walk, sometimes on camera, while a professional notes physical tendencies, like when the foot hits the ground and whether it rolls inward or outward. This provides data on affected posture, movement, pain levels, how much arch support is needed, and what type to wear to help prevent back pain. Once the analysis is complete, it will guide you on what to look for, such as what level of arch support, heel height, or material is best for you.

Injury Medical Chiropractic and Functional Medicine Clinic specializes in progressive, cutting-edge therapies and functional rehabilitation procedures focused on clinical physiology, total health, practical strength training, and complete conditioning. We focus on restoring normal body functions after trauma and soft tissue injuries. We use Specialized Chiropractic Protocols, Wellness Programs, Functional and integrative Nutrition, Agility and mobility Fitness Training, and Rehabilitation Systems for all ages. Our programs are natural and use the body’s ability to achieve specific measured goals rather than introducing harmful chemicals, controversial hormone replacement, unwanted surgeries, or addictive drugs. We have teamed up with the city’s premier doctors, therapists, and trainers to provide high-quality treatments that empower our patients to maintain the healthiest way of living and live a functional life with more energy, a positive attitude, better sleep, and less pain.

Benefits of Using Custom Foot Orthotics


Centers for Disease Control and Prevention. (2019). Back, lower limb, and upper limb pain among U.S. adults, 2019. Retrieved from

Harvard Health Publishing. (2014). Posture and back health. Harvard Health Education.

American Academy of Podiatric Sports Medicine. Ayne Furman, D. F., AAPSM. (2024). How do I know when it is time to replace my athletic shoes?

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Professional Scope of Practice *

The information herein on "The Link Between Footwear and Back Pain: How to Find Relief" is not intended to replace a one-on-one relationship with a qualified health care professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional.

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Our information scope is limited to Chiropractic, musculoskeletal, acupuncture, physical medicines, wellness, contributing etiological viscerosomatic disturbances within clinical presentations, associated somatovisceral reflex clinical dynamics, subluxation complexes, sensitive health issues, and/or functional medicine articles, topics, and discussions.

We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system.

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We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez, DC, or contact us at 915-850-0900.

We are here to help you and your family.


Dr. Alex Jimenez DC, MSACP, RN*, CCST, IFMCP*, CIFM*, ATN*


Licensed as a Doctor of Chiropractic (DC) in Texas & New Mexico*
Texas DC License # TX5807, New Mexico DC License # NM-DC2182

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Dr. Alex Jimenez DC, MSACP, RN* CIFM*, IFMCP*, ATN*, CCST
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