Best Shoes for Lower Back Pain

Many individuals who experience chronic lower back pain work with physical therapists who use therapeutic exercises and various tissue mobilization techniques to improve quality of life. In particular, the physical therapy regimen:

• Targets back injuries
• Lessens scar tissue
• Reduces inflammation 
• Helps relax tense muscles
• Boosts oxygen and nutrient flow to the affected region
• Strengthens weak muscle tissue or spinal discs linked to back pain

This approach to pain management helps increase flexibility, range of motion, and mobility. However, a physical therapist may also discuss how things such as footwear and orthotics can reduce the risk of recurring lower back pain. 

Shoes that offer proper arch support and reduce weight-bearing strain on the spine are optimal for people with back pain. However, before we get into the best types of shoes, here’s a closer look at the types of shoes that can worsen lower back pain.

Worst Shoes for Lower Back Pain

The worst shoes for people with lower back pain are flip flops, high heels, and flat shoes. Although these types of shoes are popular, they can lead to the onset of lower back pain or make it worse due to the muscle imbalances they cause. This is because they change the way people stand, walk, and run. In other words, people’s bodies move abnormally due to these types of shoes and they may also cause poor posture. 

Flip Flops

While flip flops are easy to slip into, breezy, and appear to be comfortable, they are very similar to flat shoes that do not provide any true support for the feet. Furthermore, people have to slightly bend their toes to keep flip flops from falling off while walking or running. This reduces the ability to properly engage the front of the foot when moving forward, and causes the hips to work harder to keep the torso moving forward while running or walking. 

Over time, lower body fatigue will begin to develop along with muscle imbalances in the back of the legs, as well as tenderness in the lower back. Extremely thin flip flops can cause the most substantial damage because they provide little to no support for the toes. They do not cushion the heel either, leaving it susceptible to the full impact of the ground and the body’s weight that bears down on it. 

High Heels

High heels are a particularly problematic form of footwear that can lead to lower back pain because it alters the curvature of the spinal column. People also tend to stand in unnatural positions while wearing high heels. 

High heels are associated with the wear and tear of ligaments of the spine. Wearing high heel shoes can even weaken discs between vertebrae (spinal bones) due to the abnormal spinal curvature they typically cause. This means that while high heel shoes aren’t ideal for anyone, people who typically experience lower back pain while walking, sitting, standing, or getting up from a seated position should avoid wearing them. 

High heels are not the only problematic types of heeled footwear though—short heels on dress shoes, spiked sneakers, and even cowboy boots can lead to lower back pain. Really, the angle of any heel that is one inch or longer may cause a person to walk with an arched back and knees that are slightly bent. This causes the quadriceps to work extremely hard to compensate for poor posture. The strain on the body can also affect muscles in the back, which will make back pain worse.

Flat Shoes

Most flat shoes do not offer any form of support for the feet while people are moving around. Reports also indicate that flat shoes can cause about 25% more pressure on the feet with every step than high heels do. 

This type of impact pressure builds up over time, causing strain on the hips and lower back. The lack of arch support and proper padding can also cause ligaments and tendons in the feet to overstretch. All of these problems cumulate into a larger issue for the torso and eventually overall body pain may develop. 

Even though a lot of people prefer flip flops, high heels or flat shoes, there are many footwear options that offer proper support.

Best Shoes for Chronic Pain

The most highly recommended shoes for anyone, including people who suffer from chronic lower back pain are running shoes, arch support boots, and shoes with orthotics or special insoles.

Running Shoes, Fitness Shoes, Tennis Shoes

Running shoes, also known as fitness or tennis shoes, are some of the best shoes for lower back pain. They are usually designed to target different types of physical issues and tennis shoes that fit specific needs are widely available. In particular, running shoes that reduce excessive flexing of arch of the foot, while ensuring that the foot remains properly level as steps are taken, help prevent weight-bearing strains that can lead to lower back pain. Proper arch support also decreases the amount of pressure that is placed on different joints during strenuous activity.

Due to the proven benefits of running shoes, various styles are made to accommodate people who have a low, natural, or high arch. Many running shoes also have contoured insoles that support the arch. Additionally, there are running shoes that are specifically designed for motion control, stability, or cushioned (padded) support.

It can be confusing to choose from all the different shoe styles, so it's best to consult with a Physical Therapist or visit a specialized shoe store where a professional can guide the decision-making process. A well-trained Physical Therapist can help identify your running or walking style and discuss potential health issues (e.g., chronic lower back pain) the shoes need to address. 

Certain types of shoes carry a seal of acceptance from the American Podiatric Medical Association. The seal indicates that this type of shoe has been thoroughly evaluated. It also means that these types of shoes are some of the best footwear people with chronic pain can buy.

It is also important to ensure that your running shoes offer lots of toe room and arch support. Proper toe room allows the toes to naturally flex while walking. The toes should not be squeezed together or have to grip the bottom of a shoe, as is the case with flip flops. The shoes should allow natural foot movements, without being too flimsy or too stiff. 

For people with lower back pain, natural toe flexing and optimal arch support are the two main aspects that should be considered when deciding what type of running shoe to purchase. Look for running shoes that have about one-half inch of wiggle room for the toes and do not pinch or bind the foot. Placing shock-absorbing insoles inside of running shoes can provide added stability.

Arch Support Boots

Arch support boots that keep the foot leveled during movement and decrease excessive flexing of the arches in the feet help reduce pressure on the legs and back during activity. These types of boots are typically worn by military personnel, people who work in law enforcement, or workers who spend long hours on their feet. 

In such instances, it is especially important to wear appropriate shoes to reduce the occurrence of lower back pain. Shock-absorbing insoles can also be placed inside of the boots for additional arch support. Most importantly, active individuals have to ensure that they are wearing boots that fit properly and provide the right amount of support for the arch of the foot. 

Shoes With Special Insoles or Orthotics

Even though most running shoes and arch support boots are specially designed to help stabilize the body’s core, some people benefit from additional cushion in the form of special insoles or orthotics—specially-made shoe inserts that promote proper spinal alignment, enhance back support, and improve the stability of the feet. 

Shoe inserts are non-prescription foot support insoles designed to be placed inside of a shoe. They are mass produced, pre-packaged arch support devices. Similarly, custom-made insoles that can be ordered online are typically made from a standard model. You can provide measurements including foot size or type of arch to the seller, but will receive an insole that reflects the standardized model the company has to offer. 

It is always best to work with a professional, a podiatrist (foot doctor) or a physical therapist, who can recommend special insoles that might help alleviate some of your foot and back pain. Talking to a trained professional can also ensure that you choose the shoes that best accommodate specific foot types and pain needs.

For some people, shoe inserts are effective at targeting lower back pain. Shoe inserts can be very beneficial for a variety of foot issues such as flat arches, foot and leg pain, or back pain. This is because they cushion the feet, support the arches, and comfort the feet, but they cannot correct biomechanical foot issues or help resolve long-standing foot problems that may be linked to back pain. In such cases, physical therapists may recommend custom orthotics for people who are suffering from chronic lower back pain.

Prescription, custom orthotics are specially made to support, comfort, and cushion the feet. In addition, orthotics are crafted for each individual and would not be appropriate for anyone else’s feet. Before orthotics are made, a healthcare professional (e.g., physical therapist) will complete a thorough evaluation of an individual’s legs, feet, and ankles. This ensures that the orthotics will be customized according to the unique features of a person’s foot structure and pathological problems. In other words, the orthotics are carefully designed to accommodate the way a person moves and will match the contours of their feet precisely. Therefore, orthotics are only manufactured after a complete assessment has been conducted. 

Custom orthotics are divided into two categories:

Functional orthotics – Assistive devices designed to help control abnormal movements. These types of orthotics can be used for the management of foot or back pain due to improper gait. Functional orthotics are typically crafted out of a semi-rigid material such as graphite or plastic.

Accommodative orthotics – Assistive devices that are softer than functional orthotics and designed to provide additional support and cushioning. They can be used for the management of painful calluses, diabetic foot ulcers, and other health problems that may be linked to foot and lower back pain.

Overall, the combination of proper footwear, orthotics, and physical therapy is quite beneficial for people who are suffering from lower back pain. Physical therapists can perform specific strengthening and stretching techniques that target inflammation, poor posture, and limited range of motion. 

They can also fit their clients with useful assistive devices, including customized insoles (orthotics) to further improve stability and support for the feet or back. During physical therapy sessions, the therapist teaches the patient how to properly use such devices and perform specific exercises while at home or in the office. They also provide a better understanding of the importance of using good posture at all times to help prevent lower back pain from recurring. 

Summary

In summary, if you suffer from chronic lower back pain, your shoes may be the culprit. Wearing flat shoes, high heels, and flip flops, in particular, can damage your back. The best types of shoes for back support or lower back pain are running shoes (tennis or fitness shoes), arch support boots, or shoes with special insoles or custom orthotics.

One of the well-trained physical therapists at FYZICAL can help you select appropriate footwear and demonstrate therapeutic exercises that will help to decrease or completely resolve your lower back pain. Although it seems like a small step to take, wearing the right type of shoe or utilizing a custom orthotic can dramatically improve your quality of life.

FYZICAL offers a wide variety of physical therapy services by qualified providers across the U.S. To find a FYZICAL Therapy & Balance Center near you, visit our website at FYZICAL.com. Our highly skilled therapy providers are 100% focused on your optimal health so you can Love Your Life®!

To learn more about how FYZICAL Therapy & Balance Centers can help you, download our free e-book.