When Orthotics Can Treat Low Back Pain

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When Orthotics Can Treat Low Back Pain
Guest Clinical Editor: Nicholas Sol, DPM, CPed

Q: What have you found to be most effective when prescribing custom orthotics specifically for patients who have low back pain?
For Dr. Sol, one of the most effective strategies is assisting with limb lift. In the average adult, each lower extremity accounts for 15 percent of total body weight. Each leg weighs approximately 18 pounds in an average 120-pound patient. Since we walk at 90 to 120 steps a minute, Dr. Sol says that represents a cumulative lifting load of 810 to 1,080 pounds per side in each walking minute.
“Compensating for failed limb lift mechanics causes many gait-related repetitive injuries to the low back," says Dr. Sol.
Dr. Williams favors an in-shoe pressure system to provide symmetric function in both feet and lower extremities. He adds that this effectively eliminates most of the upper body compensations which perpetuate chronic low back pain. “Eliminate the limp and the patients look, feel and function much better,” he says.
Educating patients is important to Dr. Trachtenberg. “They must be committed to wearing their orthoses full time, wearing them in appropriately constructed shoes and getting involved with an interdisciplinary model of treatment if it applies to their situation,” he says.

Dr. Sol (pictured) founded the Walking Clinic, PC and practices in Colorado Springs, Colo. He is a consultant to Tekscan.
Dr. Trachtenberg has a private practice in Vestal, N.Y., and specializes in video and computerized gait analysis.
Dr. Williams is in private practice in Indiana. He is also a Fellow of the American Academy of Podiatric Sports Medicine and a Fellow of the American College of Foot and Ankle Surgeons. He is a consultant to Tekscan.

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vinayguptasays: July 11, 2010 at 10:08 pm

If a patient presents with excessive foot pronation and/or arch collapse, a torque force will produce internal rotation stresses to the leg, hip, pelvis, and low back. The result is recurring subluxations and eventual ligament instability affecting the sacroiliac and lumbar spine joints. These forces can be decreased significantly with the use of flexible, custom-made orthotics.

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