February 18, 2016 9:00 am

Are Shoes the Solution?Can the right shoes help your back pain? You’ve probably heard all kinds of claims. Most of them might sound something like this.

Your feet are your foundation. If that’s off, everything is off, including your back. Correcting your foundation with the right shoes, therefore, can help your back pain. The right shoe for you is____.”

Fill in the blank. You may hear things about rocker bottom shoes, sandals, orthotics, going barefoot, shock absorbers, padded insoles, Nike, New Balance, Sketchers, etc.  But is there really a right type of shoe? And can the right shoes really make a big difference?

The idea makes sense. But when it comes to your health, just making sense is not enough. You have to test things out and do the research. After we looked at the data that’s out there, most of these claims turned out to be more hype than hope. Here’s what we found.

Rocker bottom shoes don’t make a real difference

Rocker bottom shoes were originally made popular by Skechers Shape-Ups. Lots of people say that they have less back pain after switching to these particular shoes. Some studies have shown that people do report a little less back pain with Rocker Bottoms. However, these same studies didn’t show any decrease in pain when compared to normal shoes. People randomly gave Rocker Bottoms or regular shoes had the same amount of pain getting dressed, playing sports, walking, and other everyday actions. In one study done in Korea, the Rockers actually made things worse, causing knee problems, and leg pain in some people. Another factor to consider is that these shoes are also expensive. Overall, we don’t think they’re worth the money as there is no concrete evidence that they help with back pain.

Orthotic shoe inserts do not relieve back pain

Of all the things you might think of putting on your feet to help your back, you’d probably guess orthotic inserts would be most effective. After all, they are usually custom molded to your feet and made by professional foot doctors with years of training. Alas, if only it were so. There are all kinds of studies in this area. One particular study looked at how much back pain 50 people with orthotics had compared to 50 others who were waiting for their orthotics, and the inserts seemed to help slightly in relieving pain. In another study, new soldiers with inserts had the same amount of back pain and doctor visits as other recruits without them. After getting conflicting information like this, we turned to the Cochrane Corporation. They are a group of scientists who look at all the studies, rank them, and try to come to a conclusion based on ALL the information. Cochrane found, on the whole, people who use orthotic shoe inserts have just as much back pain as people who don’t. Again, most likely not worth the money if getting rid of back pain is your main goal.

Shock absorbers

Shock absorbers come in two flavors. The Z-coil shoe puts a spring in your step. Literally–there’s a spring under your heel. The idea is that the spring should reduce the stress and strain of walking, thereby helping with the back pain. The second approach is to put a soft pad in the shoe to absorb shocks. We couldn’t find any good data on the Z-coil. Shock absorbing insoles were shown to reduce soreness in a group of soccer players. However, there is no solid evidence that they would be a helpful long-term solution to recommend for back pain.

Is barefoot better?

There is a raging debate among runners about barefoot shoes. They have almost no support or cushioning. The idea is that the lack of support allows your foot and ankle muscles to grow stronger, preventing injuries. We haven’t seen much proof that this approach is effective for back pain. On one hand, in cultures where walking barefoot is the norm, there are not many reported instances of pain. However, there may be drawbacks from a lack of support that could be corrected by custom orthotics, but this is an area that still needs more research before we draw any conclusions. Overall, it’s a very cool idea, worth keeping an eye on.

Well, even if they don’t help, shoes can’t make things worse, right?

Wrong. Ladies, let’s get real here for a minute. No matter how great they make your legs look, you know those high heels hurt your back. Spine x-rays of a group of Chinese women in high heels showed their center of balance shifted compared to women in flats. We know from surgery on patients with scoliosis that a shift in your balance of this type is painful. This study showed that wearing high heels cause women to put extra weight on their toes and overreach your back, which could cause lower back pain among other things. Beautiful. But so bad for you. You know who you are. Stop the madness.

Long story short, back pain is horrible. Unless you consistently wear high heels, changing your shoes is not likely to make it better. There are lots of other things you can do, which we know and can prove work. Sadly, it’s just not the shoes.

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