Chronic low-back pain is a common problem throughout the world. The cost of treating low back pain in theUnited States in the tens of billions of dollars. Most treatment options address only acute flare-ups and are not useful for long-term pain management. Up to 70% of patients who develop disabling low-back pain will experience a repeat episode within one year of treatment.

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The lower spine (lumbar) and pelvis balance on the lower extremities when we walk. This balancing act can be disrupted by abnormal forces such as leg length inequalities, postural misalignments, and foot asymmetries. Over time these abnormal forces result in micro-trauma to the lower spine, weakness, and eventually pain.

The feet are the body's postural foundation. Asymmetries in the feet block forward progression as you walk. The two most common locations of blockage are the ankle and the big toe. If the heel cord (Achilles tendon) is too tight or if the great toe is unable to flex upward your body will not rock forward very efficiently. This blockage is analogous to hitting a pool ball without drawing back on the cue.

Foot asymmetry blocking your forward motion is not easy to observe. The average step lasts just 700 milliseconds. However, foot asymmetry can be accurately diagnosed with computerized walking analysis (F-Scan), slow-motion video of the patient walking, and a thorough biomechanical exam.

The use of foot orthotics (custom arch supports) to reduce excessive forces on the lumbar spine is often overlooked by health care professionals. However, recent studies are very encouraging.

A study by DiNapoli found that 77% of patients using custom foot orthotics demonstrated a significant reduction in low-back pain over a two-year follow-up period.