Why shoes could be responsible for your back pain

What are the worst shoes for your back pain? Find out here!

BSc in Health Studies, Dip.Nut
Ask Earle

24 August 2017

How can shoes cause back pain?

Our shoes and how they support our feet can have a massive impact on our body. The way our foot moves when we take a step directs how the rest of our body will follow. Although the feet seem way far off from the back they can be closely related and can contribute to back pain. This idea of moving one joint and it affecting another is called a kinetic chain. Paying attention to your footwear can help to prevent back pain caused from shoes, but which shoes are the main culprits of back pain?

Weight loss and toning shoes

First on our list is perhaps the most dangerous and the least known about: figure-fixing shoes. Toning shoes are designed with little mini pods on the soles that are similar to wobble boards which mimic walking on an unstable surface. The concept is to make you work muscles in the legs that you otherwise wouldn’t work from walking. 

However, the unusual heel results in an abnormal distribution of the body weight which can lead to strain in the Achilles tendons and injuries in the ankle, knee and back. Sketchers’ version of toning shoes (Shape-up Sketchers) had a legal dispute from customers who experienced bone fractures, hip dislocations and herniated discs as a result of the rounded sole which is designed to throw the wearer “off balance.”1

How to prevent the damage:

• Invest in regular trainers

• Do exercises to tone and lose weight

• Build strength in the ankle joints to improve stability


Everyone knows that high heels are an extremely common cause of back pain. Arguably, they are the most well-known culprit with the Spine Health Institute claiming around 72% of women wear them!While high heels may make your butt look good, any heel with an angle greater than an inch can cause countless problems in the body! High heels not only affect the spine, they negatively impact the feet, knees, and hips too! 

Wearing high heels prevents your feet from functioning properly. Wearing high heels shifts your weight forward onto the balls of the feet which adds pressure to the bones and joints. They restrict the range of motion in your foot and can lead to joint disease in the foot bones such as bunions, ingrown toenails, and hammertoe deformities.3

They also shorten and tighten the calf muscles making it difficult to extend the leg and make the quadriceps work overtime. This puts a phenomenal amount of stress on the knee joints and can pull the kneecaps out of alignment! 

And the kneecaps aren’t the only joints that are forced out of alignment from wearing those pesky heels! Moving on up to the hip joints, the hips have a fundamental role in any leg movement – running, walking etc. – so pushing them out of alignment can cause pain in associated leg muscles such as the adductors (inner thigh muscles), hamstrings, and glutes (butt muscles).

Wearing high heels pushes your chest forward and tilts the pelvis forward too. Now this unnatural posture causes pain in the lower spine, but research argues that the position caused from wearing heels can also affect a woman’s fertility and chance of getting pregnant! Health experts claim that high heels push the internal organs against the wall of the pelvis which can slow down gastric function, cause menstrual dysfunction and impair fertility.4

Wearing heels continuously can cause chronic back soreness, spasms and eventually lead to arthritis. So how do you prevent this damage from happening to your body? Well, the obvious solution is don’t wear them! However I know that, for some of us, the thought of ditching the heels is an unbearable horror. So instead why not take preventative measures to protect your body? 

Prevent the damage by:

• Opt for round-toed heels rather than pointy toes as these compress and deform the natural shape of the toes.

• Wear heels less often. Alternating wearing heels with wearing flats will reduce the amount of time you spend wearing heels.

• Wear a lower heel. The height of your heel will determine how much weight and pressure you put on the balls of the feet; 1-inch heels increase the pressure by 22% whereas the amount of pressure in 3-inch heels rises dramatically to 76%!5

• Make sure your heels fit properly and don’t restrict or cause you to slip and slide inside the shoe.

• Opt for wider block heels or wedges rather than thin heels that will challenge your balance and compromise your stability.

Flat shoes

So maybe I’ve convinced you and you’ve decided it would be best to wear flat shoes all the time, right? Maybe not! Flat shoes are next on my list of shoes that could be causing you back pain. Wearing completely flat shoes doesn’t provide any support for your feet which then has a knock on effect to the rest of your body similar to what we have observed in wearing heels. 

Flat shoes can cause tight Achilles tendons and strain in the Plantar Fascia which help to support the arches of the feet. This tightness can then result in fallen arches and cause overstretching or tearing of the tendons and ligaments in the feet. Fallen arches (or flat feet) is where the foot lies completely flat and pressed against the ground, and over time and left untreated this can lead to osteoarthritis of the knee joints.

Flat shoes put added pressure on the heel of your foot because there is little or no shock absorption from the shoe itself, so instead all this force is taken by the feet. They can also cause your feet to roll inwards (also known as overpronation) which can push the knees and hips out of alignment causing back pain.

Prevent the damage by:

• Avoiding shoes with completely flat soles

• Make sure your feet can breathe and you can wiggle your toes in your shoes

• Invest in shoe insoles that can provide extra comfort and support to the leg

• Make sure when you buy new shoes they have a cushioned sole and are shaped to support the arches

Flip flops

You probably won’t be surprised that flip flops are on my no-go list too! In order to keep flip flops on you automatically have to scrunch and cling your toes to them. Clearly walking this way is going to impact your body in negative ways. 

Often flip flops, similar to cheap ballerina shoes and pumps, offer no cushioning or stability for the sole of the foot or the toes. According to the Spine Health Institute, your foot contacts the ground differently when you wear flip flops. The added pressure on the outer edges of the foot and heel causes a slight rotation of the lower portion of your leg which causes the angle of the pelvis to tilt and increases the curve of your lower spine.6

 They also don’t have straps that keep them in place and attached to the foot which easily results in sprains. Flip flop wearers take shorter strides which can cause the ankle to collapse inwards, similar to flat shoes. These shorter strides, specifically tailored to flip flop wearing, will put extra strain on our feet, hips and lower back muscles. Flip flops mess with the biomechanics of the foot which can permanently damage the toes, cause hammertoe, and exacerbate bunions. These conditions have a knock on effect on the way that we walk which can affect our posture and cause lower back pain.

Prevent the damage by:

• Buying flip flops with a sturdier sole

• Don’t wear flip flops to walk long distances, drive, or play sports

• Replace your flip flops every 3-4 months

How to relieve back pain caused by shoes

• Yoga

Gently stretching or doing some yoga targeted towards relieving your back pain can help to counteract the pain caused by the wrong shoes. 

• Herbal remedies

Relief from back pain can be hard to accomplish because we use our back in so many activities in so many different ways, but herbal remedies can definitely help! Atrogel can be applied directly onto the painful area to help reduce pain and inflammation.

• Heat

Going for a hot bath or applying a hot pack to your back can help to increase the oxygen and nutrient flow to muscles. Heat stimulates the sensory receptors in the skin which means that applying heat to the back can decrease transmissions of pain signals to the brain.7

• Additional help

If your back pain becomes really debilitating and unmanageable I would always suggest going to a podiatrist, physiotherapist, or osteopath. A specialist professional will be able to identify the source of your back pain and be able to recommend exercises that you can do to relieve back pain. They will also be able to identify if you need special shoe insoles or prescription orthotic to help with back pain caused by poor footwear.

1 https://www.hg.org/article.asp?id=24928
7 https://www.spine-health.com/treatment/heat-therapy-cold-therapy/benefits-heat-therapy-lower-back-pain

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