Choosing the Right Shoes for Back Pain
This content was medically reviewed by Baher S. Yanni, MD, on February 7th, 2019.
Back pain is one of the most common ailments in the United States and affects eight out of 10 people at some point throughout their life. Back pain might be a small sharp pain or a dull ache that persists all day. Many different factors can cause back pain from poor posture to lack of exercise. However, sometimes back pain is linked to sore feet and uncomfortable shoes.
If your feet are causing or contributing to back pain, a change in shoes might make a huge difference. The right pair of shoes can provide the support you need for your back while you’re at work, at the gym or running errands. The wrong pair can cause or exacerbate back pain symptoms.
How do you know which shoes are best for back pain relief? In this post, we will show you how to pick the best shoes for back pain and the factors you need to consider when shopping for new shoes. Once you have the right shoes for your feet, you may notice reduced back pain right away.
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Why Shoes Are Important for Back Pain
Your feet provide the base for the rest of your body. When you wear uncomfortable shoes, they create a chain reaction on your ankles, knees, hips and ultimately, your back. Your feet need adequate support to prevent pain while you stand, walk or run. Without proper support, you might adjust your gait or posture and set your spine out of alignment to compensate for the lack of support in your shoes. You also need shoes that absorb impact as your foot hits the ground so that other parts of your body do not have to bear the force of the impact.
Overall, a good pair of shoes improves and stabilizes the position of your feet, which, in turn, improves your gait and posture. Good posture helps prevent muscle strain and pain in the back because it keeps everything in correct alignment and allows muscles, bones and joints to work efficiently.
If your shoes are causing your back pain, it’s time to replace them. However, before you head to the shoe shop, you might want to visit your doctor if you’ve been experiencing back pain for more than a few days to rule out other possibilities.
Visit Your Doctor First
Your doctor or spine specialist will identify the source of your back pain, and they might even recommend shoes for your specific foot shape. Usually, a doctor will take X-rays of your back to look for a spine injury or other health issue, and they will ask you questions about your job and lifestyle. They will try to rule out all of the possible causes of your back pain such as a fracture or herniated disc. Once you and your doctor determine your shoes are the culprit, you’ll be in a good position to choose a new pair of shoes.
Tips for Choosing the Best Shoes for Back Pain
Can you recall a time when you wore shoes that did not fit right but looked great? You probably felt a wave of relief when you got home and took them off. You may also remember experiencing lower back pain after a day of walking around or standing in a pair of unsupportive shoes, especially if you spent a lot of time on a hard surface.
Good shoes aren’t about the latest trend or low prices. When you are ready to buy new shoes, make comfort and quality a priority, and keep the following tips in mind. You’ll be glad you did because nothing beats pain-free living.
1. Consider Arch Support
The arch support of your shoe should be designed to work with the natural arch of your foot. Your foot arch may either be low, neutral or high. Individuals with flat feet or high foot arches may cause the foot and ankle to overpronate. Overpronation means the foot excessively rolls downward when the foot hits the ground. This disrupts the body’s alignment and increases the impact of walking or running, potentially causing injury or pain.
To determine your foot arch type, dip your foot in water and step onto a piece of cardboard. Your footprint will tell you what your arch type is. Read your footprint in the following ways:
- Neutral arch: If the middle part of your arch in the footprint is about halfway filled in, then that means you have a normal arch, and your arch naturally supports your body weight and pronates normally. Choose shoes with firm midsoles and moderate stability in the rear of the shoe.
- Low arch: A low or flat arch will look like a complete footprint. This means your foot likely overpronates and contributes to muscle stress. Choose a walking shoe with a straight sole and motion control.
- High arch: A high arch will produce very little of your arch footprint. A high arch may not absorb shock well and can lead to excessive muscle strain. A curved sole and cushioning may help provide the shock absorption you need.
Good arch support may relieve or eliminate your back pain. However, it’s most important to choose a shoe that feels comfortable and fits properly despite your arch type.
2. Consider Cushioning
When choosing shoes, consider if they provide enough cushioning to reduce impact. Cushioning will help dissipate the shock of impact and reduce stress on your back.
The part of the shoe that protects your foot from impact is called the midsole. The midsole is located between the part of the shoe that touches the ground called the outsole, and the part that runs directly under the foot called the insole. The midsole is the external shock absorbing component and might be made of polyurethane foam, ethylene vinyl acetate (EVA) or another material. EVA midsoles are generally more lightweight than polyurethane, but polyurethane is more durable.
Generally, if you have a high arch, it might be best to choose a softer midsole. Individuals with low arches should choose firmer midsoles to provide more motion control. To test the cushioning, push your thumbnail into the midsole and determine the firmness.
3. Avoid High Heels
In the United States, billions of dollars are spent annually on fashionable footwear like high heels. High heels look elegant and often pair well with a professional wardrobe. However, wearing heels causes your lower back to arch and your chest to move forward, throwing your spine out of its natural alignment. This can lead to muscle overuse, lower back pain and possibly other back issues. High heels are also hard on the arch and ball of the foot which might lead to back pain.
- Choose heels that are no higher than 2 inches.
- Avoid wearing heels for extended periods of time throughout the day.
- Try a larger size and insert a heel cup.
- Consider taking your designer heels to a pedorthist to have them custom fit.
4. Avoid Flip-Flops
Just as high heels can cause pain, so can shoes that are too flat, like flip-flops. Flip-flops do not provide any arch support and can lead to pain in the arch of the foot, heels, ankles, knees and back. They are okay for walking short distances but should not be worn for a long time.
5. Choose the Right Fit
It may be tempting to buy shoes that do not fit quite right but are on sale. Or maybe a friend is offering a pair of shoes that look great but are a tad too tight. Many people choose shoes that do not fit well for a variety of reasons, but it’s critical to wear shoes that fit correctly in length and width. If you do not select the right size, you might walk differently and hurt your back. Here are tips for choosing the perfect fit:
- Shop later in the day: Wait until the afternoon to go shoe shopping instead of first thing in the morning. Your feet naturally expand throughout the day, so you’ll get a closer fit.
- Wear your regular socks: Wear the same socks you regularly wear to make sure the shoes will not be too tight or too big.
- Measure your feet: Ask a salesperson to measure both your feet every time you buy shoes. If one foot is larger than the other, buy the bigger size for both feet.
- Try them out: Stand in your shoes and make sure you have at least a quarter- to a half-inch space between your longest toe and the top of the shoe. Walk around and see how they feel on both hard and soft surfaces. The heel should fit snugly, and there should be enough room at the ball of the foot.
- Consider your comfort level: No matter how comfortable a company describes their shoe on the shoebox, consider how you feel in the shoes above all else.
- Check the inside of the shoe: Look for tags, seams or anything else inside the shoe that might bother your feet.
- Check the soles: Inspect the soles of the shoes and make sure they are sturdy enough to protect your feet from sharp objects as well as provide impact absorption.
- Go with the ones that fit right: Most of us have said at one point in our lives that a new pair of shoes simply needs to be broken in. Resist telling yourself this when you’re shopping for shoes, no matter how much you love the way a shoe looks. Go with the pair of shoes that fit from the start.
Lastly, many shoes in the store are a medium width, so you may need to order shoes from the manufacturer if your feet are wide or narrow.
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To summarize what we’ve covered so far, the best shoes for back pain relief are those which fit comfortably, provide adequate arch support and can absorb impact. Here are a few more tips to remember regarding shoes and back pain.
1. Consider Orthotics
If you have flat feet or high arches, you might benefit from using an arch support insert called an orthotic which provides shock absorption and cushioning specifically for your foot shape. A podiatrist, chiropractor or another physician may be able to custom-make orthotics for you.
You might also purchase inserts in a store if custom orthotics are not an option for you. To choose shoe orthotics, follow these tips:
- Choose rigid for a low arch: If you have flat feet or a low arch, choose rigid orthotics with good arch support which will control the motion of your feet. To make sure it is rigid, push down on the arch. If it moves under pressure, it is not rigid enough.
- Choose soft for a high arch: If you have a high arch, choose soft, flexible orthotics. Make sure the inserts still have some stiffness so they can support your arch.
- Stand on them: Before you remove the insoles of your shoes and insert the orthotics, test them out. Remove them from the packaging, place them on the floor and stand on them. Ask yourself if they provide enough arch support.
- Trim them if necessary: You may have to trim the orthotics around the toe area so they can properly fit into your shoe. Trim them a little bit at a time until they fit, and follow the package instructions for trimming.
- Get used to them: It may take a little time to get used to orthotics in your shoes. Place them in the shoes you plan to wear the most, and gradually increase the time you wear them. For example, wear them for two hours for the first day and remove them. Then, on the next day, wear them for four hours.
Shoe inserts can alter a pair of shoes and provide some relief for your feet and back. If you have a hard time finding comfortable shoes, you might try orthotics.
2. Replace Worn Shoes
Sometimes, it’s tough to part with a pair of your favorite shoes. However, worn shoes will not provide the support you need. For example, a running shoe loses up to half of its shock absorption after about 250 miles of use. Therefore, it might be time to replace your shoes if they show any of the following signs:
- The midsole is cracked or appears wrinkled.
- The heels are scuffed.
- The outsole has flat spots.
- The straps are stretched or broken and cannot be replaced.
- The shoes tilt to the side while resting on a flat surface
A shoe’s lifespan depends on its quality and how often you wear the shoes. For many shoes, they’ve lived full lives after a year or so of regular use.
Contact Metropolitan Pain & Spine Institute Today
Wearing comfortable shoes with good support and low heels can help improve posture and reduce back pain. However, back pain can happen for many reasons, and you may need more than a new pair of shoes depending on your condition.
The spine specialists at Metropolitan Pain & Spine Institute are here to help. Our team of spine experts is prepared to get to the root of your back pain. We will find the exact cause for your back pain and use the least invasive method to relieve your pain fast and effectively with the goal to maintain long-term relief.
This content was medically reviewed by Baher Yanni, M.D, on February 7th, 2019.