The best and worst shoes for back pain

Do you have back pain? Here’s how to choose shoes that won’t hurt and might help.

Back pain can have many causes. Maybe you overworked yourself. You may be sitting most hours of the day. Or maybe you have an underlying condition that causes back pain. If you have had back pain for more than a month, if your pain is getting worse over time, or if you have new neurological symptoms such as numbness or weakness in any part of your body, it is best to consult a healthcare professional.

But if you’ve discussed your symptoms with your doctor, or want to try some common sense advice first, it’s worth considering whether your choices shoes can contribute to your back pain.

What works best for one person may not necessarily work the same for others. For some people, for example, significant differences in limb length can lead to problems that are exacerbated by wearing the wrong shoes.

But for many people, simply finding shoes that fit well, have enough cushioning and provide the right kind of support is a step in the right direction.

What to look for when choosing shoes

Shoes, trainers and other footwear should be comfortable and not pinch or irritate any part of the foot, even when new. When trying on shoes, take the time to walk in them and pay attention to how they feel. No matter how they look, don’t buy shoes that are too tight, too loose, unsupportive, or uncomfortable in any way.

To increase your chances of find a comfortable shoe, here are some features to look for:

Moderate heel height

Shoes with a slight heel are best. The fact that your heels are slightly elevated allows your ankle to turn a little and pivot differently.

A heel the same height or lower than the toe of the shoe, on the other hand, affects the way your leg, and, in turn, your pelvis, rotates. This affects your spine and lower back and causes back pain. A heel of less than 5 cm is preferred, never higher than that.

While heel height is more often a concern when it comes to women’s shoes, the concept of heel height as a positive also applies to men. That said, most men’s shoes have a neutral heel height, so the heel and toes are on the same level…and men have a lower incidence of back pain than women.

Cushioning and shock absorption

In addition to the height of the heel, the way the heel of the shoe absorbs shock is important for the feeling that you experience at the level of the back. Some people hit the ground harder than others with their heel when walking, sending a shock down their legs and towards their back.

The problem may be exacerbated in people wearing dress shoes, a cork heel can help. The same goes for a rubber heel or wedge shoes. The sweet spot is in the middle: a shoe that is neither too hard nor too soft.

When it comes to running shoes, “maximalist” shoes with lots of cushioning are popular among ultramarathoners and people with high foot type.

According to an article published in January 2020 in Podiatry Today, opting for a cushioned shoe may allow runners to absorb more shock and therefore may be a good option for older runners, runners with history of stress injuries or runners who run primarily on hard surfaces like cobblestone. Rocker soles aren’t for everyone, but they can be helpful in some situations. These are thick soles that are curved upwards at the front and sometimes at the back of the shoe, and which allow the foot to perform a normal walking motion with less pressure on the joints and on the ball of the foot, in general.

Rocker soles are a common feature of therapy shoes prescribed for people with diabetes-related foot problems, and they have also become more common in some models of sneakers and walking shoes marketed to the general public.

Sneakers with thick rubber soles reduce the impact on the heel. They can be helpful in treating plantar fasciitis, as well as knee, hip and back pain.

Sandals with arch support

In general, sandals and flip flops don’t offer much support. But special sandals, orthopedic style, are an exception. They provide adequate arch support.

Shoes to avoid if you suffer from back pain

The longer you wear a pair of shoes for a long time, and the longer you intend to stand or walk in them, the more important it is that they provide good support where you need it.

Here some red flags when it comes to footwear:

Beware of negative heels

Non-orthopaedic flip-flops, fine they are not good for your feet, are okay for a quick walk around the neighborhood or to the beach, but they are not recommended for all day use, especially if you already suffer from back pain.

Most flip flops actually lower your heel under your toes, creating a negative heel. Although she notes that they provide some cushioning, this is a “false sense of cushioning” because the sole of a flip-flop is usually not thick enough to absorb the shock of every step.

Indoor slippers have the same problems as flip flops but, of course, not many people wear slippers when they go out. So as long as you only wear slippers at home, you don’t have to worry too much about them.

Beware in general of “anything with a negative heel”. This includes flat moccasins and ballerina type shoes with a very flat sole. These types of shoes cause rotation of the pelvis which can aggravate back pain.

A problem that is too hard or too soft

Keeping in mind that you want your shoes to absorb shock, it’s best to avoid “totally hard” shoes. Typical dress shoes fall into this category, due to their lack of cushioning.

Shoes with a memory foam cushion or air cushion may -be more problematic, as they don’t offer the right kind of support in addition to their cushioning. However, these types of cushioning, when combined with a supportive heel, aren’t that bad.

Minimalist shoes are generally not recommended

Minimalist shoes, sometimes called “barefoot” shoes because of their very thin soles, are not good for the back. People who already have back problems usually find that these types of shoes do not help alleviate these problems and can cause back pain.

Again, these shoes rotate the pelvis differently shoes with thicker soles. For what it’s worth, when it comes to wearing minimalist shoes, it’s up to each person to decide what’s comfortable for them.

Casual sneakers can lack support

Casual sneakers, such as the classic Converse Chuck Taylor All-Stars, are problematic because they are flat, narrow and lack support.

Where to find help choosing your shoes

If you need more personalized shoe recommendations, consult a podiatrist trained in biomechanics and able to identify problems such as gait abnormalities. Some shoe stores have trained staff who can make shoe recommendations based on foot shape and measurements.

Remember that if you still have back pain despite the wearing proper shoes, it may be time to look for other causes of your pain. Your GP is a good place to start looking for signs of medical issues that may be causing your back pain and to consider aspects of your lifestyle that may be contributing and changes you can make. .

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