Foot and Low Back Pain: How they are interconnected

Foot and Low Back Pain: How they are interconnected

Previous to me becoming a Podiatrist I had no idea how interconnected low back pain is related to foot and ankle problems. As a Podiatrist I have good relationships with spine and back physicians since their patients suffer from foot and ankle problems and vica versa.

How is the back related to the foot and ankle?

The anatomy and physiology of the foot and ankle isn’t exclusive to the foot and ankle. As a Podiatrist when I do a foot exam I focus on 4 different components. I focus on the vascular system, dermatological exam, an orthopedic exam and a neurologic exam. These 4 components of an exam are not exclusive to the foot and they need to be investigated further if there is a deficit in one of them.

In relation to back problems, I will usually see a deficit in the neurologic exam in the foot.

What exactly does this mean?

Let’s say a patient has a pinched nerve or disc degeneration in the L4-L5 Lumbar Spine, which is causing them symptoms of pain in their low back. They will most likely have numbness, lack of sensation, weakness or burning in different parts of the foot. Many times a patient with low back pain will complain of pain that shoots from their back to their feet. It is the podiatrist and neurologist job to figure out if the pain is exclusively from the back or if there is a foot component as well.

Many times when I have this dilemma of where the pain is coming from I will order a Nerve Conduction Test and an Electromyography Test (EMG). These tests will be able to determine exactly where the problem is arising from.

How do you treat foot problems related to back problems?

When a patient presents with back and foot problems I am honest with them and I let them know that I will try to cure their foot and ankle problems but they may still have residual problems in their back. Many patients can be helped with their foot problems by changing their shoe gear, wearing a custom orthotics, ice, stretching and even anti-inflammatory medication. Physical therapy is a great modality which can focus on the foot and ankle as well as strengthen the core muscles to help alleviate back problems. In addition, there are medications to help with nerve pain, such as Gabapentin (Neurontin) and Lyrica (Pregabalin).

In conclusion, when a patient presents with symptoms in the foot and the back I like to take a multi system approach. I like to engage the patient, myself, their neurologist or back specialists and a physical therapy. Many patients with these symptoms present feeling that there is no treatment to help them, but with a little effort their pain can be reduced significantly.

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