Lower back pain is the leading cause of disability worldwide
In an article published by The Lancet in 2018The Lancet in 2018, it was reported that lower back pain is the leading cause of disability worldwide. (Hartvigsen et al., 2018). In fact, as of 2022, there are 570 million prevalent cases worldwide, according to the World Health Organisation.
Your poor back just doesn't get a break - you already know that sitting for prolonged periods can be a major cause of back pain. And, just as equally, being on your feet for extended periods may also cause back pain! Don't despair though, we have your back! If you read on you will find suggestions on how to prevent yourself from becoming a statistic and to help you, if you already have lower back pain.
We specialise in helping people with back pain
Here at Enjoy Better Health, we specialise in helping people reduce their pain and also offer remedial functional movements to support your recovery and maintain the fluidity of mobility. Bowen is a hands-on physical therapy that works over the soft tissue, through the deeper tissues, including the organs and encourages the nervous system to reset into the parasympathetic mode. This in turn stimulates the body's innate ability to heal on all levels.
Standing causes increased pressure on your spine
There are many instances where you may find yourself on your feet for several hours, causing increased pressure on your spine which makes the muscles in your lower back tighten, resulting in pain. In fact, there are so many different parts of your back that can go wrong, especially if you do not hold a good posture due to habit, from previous injuries or because of the nature of your work. The lower back is the most used part of your spine, with bending, twisting, weight-bearing, and jarring making it susceptible to injury and of course, wear and tear over time. If you already have a spinal condition, standing can trigger inflammation which will increase pain in the lower back area.
How can you prevent back pain?
I'm going to focus on your feet; they are like tripods on which your entire body weight is balanced, from the little toe across to the big toe and heel.
Taking a step requires the whole foot; striking at the heel, placement of the whole foot to ensure stability, and a push-off at the metatarsal pad (ball of the foot) and toes. Without this entire combination of processes, you compromise your balance and cause tension up through the ankle, leg, knee and hip to your lower back and beyond.
So, what are you wearing on your feet?! Do your shoes allow you to take a step without restricting the movement of your feet or toes? Can you feel the surface that you are walking on? Fashion shoes, both for women and men, which are worn regularly and for prolonged periods, will cause structural changes in the feet and associated soft tissues. These changes will affect how you walk and the dynamics of the entire body, including the lower back.
Those high-heeled pointed-toe shoes of yours look amazing...ly uncomfortable and crippling. I have a challenge for you: in completely bare feet, go up on your toes. You probably found yourself toppling forward, trying to keep your balance, perhaps scrunching up your toes. Try again, but this time find something to squeeze your toes together. Did you lose your balance? Did you feel tension through your legs, knees and hips, as you tried to stabilise yourself? In addition to losing your balance and running the risk of twisting your ankle, wearing high heels puts too much pressure on the narrow bones in your feet, causing inflammation of the bones and the surrounding nerves, which often results in hairline fractures.
What about those solid-based platforms and thick-soled trainers? Platform shoes and fashion trainers, prevent the proper function of the foot and the natural walking motion. Also, to be sure of our footing, we need to feel what we are walking on. If you are not able to accurately judge what you are walking on, you will strain or jar your lower back.
And, from one extreme to the other; ballet flats or pumps, and flip-flops or slides. These types of footwear do not provide any support for the foot and because there isn't anything to secure the shoe around the foot, the toes curl up trying to grip onto the shoe, to keep it on, causing the plantar fascia (a band of tissue on the sole of the foot) to become inflamed.
Brogue-style shoes for both women and men can also cause structural changes to the feet, even though they are flat and held on securely.
The foot's natural shape is not accommodated in a shoe that narrows into a point because our natural foot shape fans out towards the toes. Often, the big toe is compressed and bent inwards to the other toes, causing a bunion. Also, if the leather is particularly stiff, it digs into the soft tissue causing blisters and nerve pain. All of these structural changes will affect how you walk and the dynamics of the entire body, including the lower back.
What are the best shoes to prevent lower back pain?
According to Hylton Menz, a podiatrist and professor of biomechanics at La Trobe University in Australia, shoes should have a low, broad heel, a thin and flexible sole, and some kind of lace, strap or Velcro to ensure the shoe stays firmly attached to the foot. (Heid, 2018) If someone already has spinal issues then they might consider a professionally fitted orthotic, to provide adequate arch support, as well as shock absorption on striking the heel for each step.
The best way to judge if a shoe is a right fit for you, is to place your foot over the sole of the shoe and see if the width of your foot and toes are within the borders. If not, then it is not the most suitable or appropriate shoe for you!
Like wearing high heels, ballet flats or other fashion shoes?
try to keep heels below 2 inches and either choose a shoe with metatarsal padding or add an insert, to reduce the pressure on the bones
add an arch support to ballet flats and secure the shoe to the foot with elastic or ribbon, to prevent them from slipping off
go for a thinner-soled trainer or shoe, to allow for the proper mechanics of walking
TLC for your feet and back
If wearing fashion shoes is your go-to trendy accessory, here are some solutions and remedial functional movements you can do during the day and after you take your shoes off.
During the day:
take every opportunity to kick off your shoes and allow your toes to spread and the muscles to relax
when taking a break, take your shoes off and lace your fingers through your toes and rotate your ankles with your hand
make sure your knees are slightly soft when standing for prolonged periods, to prevent locking out your knees and tilting your pelvis forward
with or without your shoes, squat down so your bottom touches your heels, to unravel your back and realign your spine
draw a figure of eight with your hips, to mobilise the pelvis and hips and prevent the muscles from seizing up, and relieve strain on your lower back. This can be subtle or exaggerated, depending on your circumstances
At the end of the day:
soak your feet in Epsom salts and if they are swollen, wrap them in a bandage soaked in apple cider vinegar for up to 2 hours (removing if you experience any tingling on the skin)
lay on your back and with your legs outstretched, flex one foot and drag the heel up towards your body. This helps the hips, knees and ankles. Point the foot and push the leg back down. Repeat on the other side. Repeat the sequence 10 times
lay on your back and have both knees bent with the feet on the surface and extend your arms out to the side (at 90 degrees). Allow both knees to slowly drop to one side and then to the other. You should be feeling some resistance down the side of your body and into your lower back. Repeat for a minimum of 10 times on each side
maintaining the same position as above, push through your feet to create a subtle sacral tilt, without lifting the pelvis off the surface. Then release and push out your bottom. Repeat up to 10 times
stand on a step or book on just the metatarsal pads and allow the heels to alternately drop down, then raise up on your toes. This mimics functional walking. Take at least 50 steps
spend the rest of the day in bare feet
if you have chores, use your feet and toes to clean the floor and pick up clothes! This helps with hip mobility, as well as strengthening the muscles of the feet, to support your back.
If you already have a back condition
The International Spine Institute recommends that if you have a job that requires you to stand all day, there are things you can do to minimize your risk of back injury:
move around as much as possible, rather than standing in a static position. This will help to increase circulation in your spine and limit muscle fatigue
take frequent breaks from standing, to help with fatigue and pain in your lower back
ensure that you stand with the correct posture, with soft knees and your weight evenly distributed across the foot tripod (metatarsal pad and heel). Bring your shoulders back and down, allowing your arms to hang by your sides. Your head is equally important, lifting at the crown and pushing your chin towards the spin
shift your weight from one leg to the other or from heel to toe
Your lower back is the greatest stress-loading area in the body
How you walk and stand will have a direct impact on the health of your lower back. If there is limited fluidity of movement due to a job requiring you to stand for prolonged periods or from restriction as a result of structural changes, then the muscles supporting the spine and the spine itself will become strained and cause pain. What you wear on your feet may cause structural changes to the feet and up through the ankles, knees, hips, lower back and upwards.
Do you need help correcting your posture, increasing fluidity of movement and with individual suggestions to save your back and prevent pain? We offer a visual assessment, functional movements, lifestyle changes and Bowen therapy to relieve pain and restore back health. Call us on 07968722646 or email amanda@enjoybetterhealth.co.uk to arrange a discovery call and book an appointment.