By: William M. Austin, DC, CCSP, CCRD
The Baby Boomer generation is that group of individuals born between 1946 and 1964. There are approximately 76 million baby boomers and this group comprises the largest single segment of the American population. So, if you’ve noticed the median age of your patients has changed, it could be due to the fact that the baby boomers are getting older and beginning to feel the results of many changes taking place in their bodies. About 80% of all men and women will suffer from back pain at some time during their lives, and an estimated third of these baby boomers are struggling with it right now.
Chronic low back pain is usually the result of some form of structural weakness or failure.1 Structural weaknesses are brought about by biomechanical errors, structural asymmetries, tissue weaknesses, and imposition of excessive external loads (Table 1). All these factors result in repetitive microtrauma, which is the underlying cause of most low back pain/injury. The source of these conditions must be recognized and treated in order to prevent additional breakdown. And that source is often an imbalance/condition in one or both of the feet.
Causes of Chronic Lumbar Spine Breakdown
Excessive external loads
The Pedal Foundation
The feet are the foundation of the body. Statistics show that at birth, most of us have perfect feet. By age 20, 80% of those “perfect feet” have developed some type of problem, and by age 40, nearly
everyone has a foot condition of some sort. Many foot conditions eventually contribute to health concerns farther up the Kinetic Chain (Fig. 1), especially the generalized condition of “back pain.” Therefore, it’s in the best interest of both you and your patient to be able to spot a potential low back problem before it is allowed to affect a patient’s health and/or lifestyle.
During standing and walking (not to mention running in athletes) the lumbar spine and pelvis balance on the lower extremities. If leg or foot asymmetries or alignment problems are present, abnormal forces are transmitted along the closed Kinetic/Kinematic Chain, interfering with spinal function.2 When excessive pronation and/or arch collapse is present, (Fig 2) a torque force produces internal rotation stresses to the leg, hip, pelvis and low back.3 This is where the use of foot orthotics is most effective, and can make Chiropractic adjustments more effective and long-lasting.
Causes of Back Pain
Asking your patients a few simple questions can provide valuable insight into the cause(s) of their back pains. During your examination of a patient who expresses the vague complaint, “My back hurts,” make sure to get answers to the following ten questions:
- Do you stand or walk on hard surfaces for more than 4 hours daily?
- Do you participate regularly in any physical sport (basketball, baseball, tennis, golf, bowling, etc.)?
- Are you age 40 or over?
- Have you ever had a prior injury to your knee, back or neck?
- Do your shoes wear unevenly?
- Do you have joint pain while standing, walking or running?
- Is one of your legs shorter than the other?
- Do you have knock knees or bow legs?
- Do you have any obvious foot problems (bunions, corns, flat feet, etc.)?
- Do your feet “toe out” when you’re walking?
If your patient gives an affirmative answer to any of the above questions, consider this patient a likely candidate for flexible, custom-made orthotics. Improving the foundation can have a very positive effect on the whole Kinetic Chain: the foot/ankle complex, knees, pelvis, and spine. Reducing biomechanical stress helps reduce pain and discomfort.
An independent survey conducted at Northwestern College of Chiropractic reported that 82% of patients wearing Foot Levelers orthotics felt they helped their condition overall, and 8 out of 10 wearers would refer others to you to get them.4 Foot Levelers’ InMotion functional orthotics (Fig. 3) is built with Celliant®, which increases tissue oxygen up to 10.2%, and infused with silver for strong odor control.
Prescribing Foot Levelers orthotics can help your patient and can also be a proven asset to the growth of your Chiropractic practice.
- Fulton M. Lower back pain: new protocols for diagnosis and treatment. Rehab Management 1988; Nov/Dec:39-42.
- Keane GP. Back pain complicated by an associated disability. In: White AH, Anderson R., eds. Conservative Care of Low Back Pain. Baltimore: Williams & Wilkins, 1991:307.
- Hammer WI. Hyperpronation: causes and effects. Chiro Sports Med 1992; 6:97-101.
- Northwestern College of Chiropractic (NWCC). Summary of Market Research Findings: Surveys of Chiropractors and Patients. Bloomington MN: NWCC, 1997.
About the Author
Dr. William M. Austin is a dynamic public speaker and prolific writer, with extensive experience in the fields of biomechanics, postural analysis, and rehabilitation.