PM&R News   •   October 13, 2017

Low back pain remains one of the most common conditions for which individuals seek medical care. When it comes to chronic low back pain, many treatments are ineffective and opioids should be avoided. During the examination of patients with chronic low back pain, foot alignment and dynamic foot positioning is often not performed and is overlooked as a potential contributor to the condition. This study looked at 255 subjects with low back pain for greater than 3 months and randomized them into three groups. The groups consisted of shoe orthotics, shoe orthotics plus chiropractic care, or waitlist for shoe orthotics.  After 6 weeks, low back pain decreased more in the orthotic and orthotic plus chiropractic group. This improvement remained statistically significant for up to 12 weeks.  In addition, the orthotic group and orthotic plus chiropractic care group had statistically significant improvement in disability scores for up to 12 months. Early shoe orthotics for low back pain should be considered in all patients and attention should be paid to foot alignment and positioning during the physical exam.