Clinical Research in Orthotics and Lower Back Pain

There is currently insufficient evidence to definitively recommend shoe insoles for specific types of lower back pain, such as a herniated disc or degenerative disc disease. However, there is emerging clinical evidence supporting the use of foot orthotics as a potential treatment option for lower back pain in general.

• See Foot Orthotics for Chronic Low Back Pain

Some of the research and conclusions supporting the use of foot orthotics are controversial. For example, a 2013 systemic review of relevant studies concluded that there is insufficient evidence to support the use of shoe insoles or foot orthoses for treatment of lower back pain, citing problems with the studies reviewed—such as a small number of trial participants, which may have weakened the studies’ conclusions.³

Foot problems and lower back pain

Many studies have found evidence of foot problems associated with lower back pain. For example, a December 2013 study examined foot posture and function and its possible relationship with low back pain.⁴The study included a large patient population of 1,930 subjects, and concluded that foot orthoses may have a role in the prevention and treatment of lower back pain, as the incidence of pronated foot function (rolling in of the ankle and flattening of the medial arch) was found to be associated with low back pain—with a higher incidence in women.