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- DOI 10.18231/j.ijos.2025.024
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CrossMark
Study of association of back pain with foot disorders like calcaneal spur, foot span, foot pain, and foot posture
- Author Details:
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Ajay Chandanwale
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Dinesh Ramesh Kabre
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Vishal Anand Mangwalkar
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Mohit Arun Kakad *
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Sharath N.K
Ajay Chandanwale
Dinesh Ramesh Kabre
Vishal Anand Mangwalkar
Mohit Arun Kakad *
Sharath N.K
Background: Back pain is one of the most prevalent musculoskeletal disorders, significantly impacting individuals' quality of life and work productivity. Despite extensive research on its risk factors, the role of foot disorders—such as calcaneal spur, foot span abnormalities, foot pain, and foot posture deviations—in contributing to back pain remains underexplored. Given that the foot serves as the foundation for posture and locomotion, any structural or functional abnormalities may lead to compensatory changes in spinal biomechanics, potentially exacerbating back pain.
Aims & Objective: This study aims to investigate the association between low back pain (LBP) and foot disorders, including calcaneal spur, foot span variations, foot pain, and abnormal foot posture.
Materials and Methods: A prospective observational study was conducted at BJ Medical College, Pune, Maharashtra, over two years. A total of 100 patients with both LBP and foot disorders were included. Clinical, radiological, and biomechanical assessments were performed, including foot measurements, spinal alignment evaluations, MRI analysis, and Visual Analog Scale (VAS) scoring. Statistical analyses were conducted using paired/unpaired t-tests and Chi-square tests, with p < 0>
Results: The study found a significant association between LBP and BMI (p = 0.004), with normal-weight individuals reporting higher LBP scores. MRI findings revealed that 39% of patients exhibited L4-5-S1 disc degeneration. High pelvic incidence (>60°) was significantly correlated with severe LBP (p = 0.005). Foot abnormalities, including pes planus and increased foot span, were common in LBP patients. Foot pain severity correlated with LBP but was not significantly associated with BMI or serum uric acid levels.
Conclusion: Foot disorders play a crucial role in the development and severity of LBP. The findings emphasize the need for integrating foot assessments into LBP management for effective treatment strategies.
Keywords: Back pain, Foot disorders, Calcaneal spur, Foot span, Foot posture, Lumbar spine, Biomechanics, Pelvic incidence.
References
- Knezevic NN, Candido KD, Vlaeyen JWS, Van Zundert J, Cohen SP. Low back pain. Lancet. 2021;398(10294):78–92.
- Abbafati C, Machado D, Cislaghi B, et al. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis GBD 2019 Diseases and Injuries Collaborators. Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020;396(10258):1204–22.
- Goel S. Non‐spinal causes of back pain: an ‘undiagnosed’ diagnosis. J Med Res Innov. 2019;3(2):e000172.
- Hoy D, Brooks P, Blyth F, Buchbinder R. The epidemiology of low back pain. Best Pract Res Clin Rheumatol. 2010;24(6):769–81.
- Wang L, Ye H, Li Z, Lu C, Ye J, Liao M, et al. Epidemiological trends of low back pain at the global, regional, and national levels. Eur Spine J. 2022;31(4):953–62.
- Chen S, Chen M, Wu X, Lin S, Tao C, Cao H, et al. Global, regional and national burden of low back pain 1990-2019: A systematic analysis of the Global Burden of Disease study 2019. J Orthop Translat. 2022;32:49–58.
- Shekhar S, Rao R, Nirala SK, Naik BN, Singh C, Pandey S. Prevalence of acute low back pain with risk of long-term disability and its correlates among medical students: A cross-sectional study. J Educ Health Promot. 2023;12:179.
- McKeon PO, Hertel J, Bramble D, Davis I. The foot core system: a new paradigm for understanding intrinsic foot muscle function. Br J Sports Med. 2015;49(5):290.
- Yu Z, Yin Y, Wang J, Zhang X, Cai H, Peng F. Efficacy of Pilates on Pain, Functional Disorders and Quality of Life in Patients with Chronic Low Back Pain: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2023;20(4):2850.
- Hicks GE, Pohlig RT, Coyle PC, Sions JM, Weiner DK, Pugliese JM, et al. Classification of Geriatric Low Back Pain Based on Hip Characteristics With a 12-Month Longitudinal Exploration of Clinical Outcomes: Findings From Delaware Spine Studies. Phys Ther. 2021;101(12):pzab227.
- Kahraman BO, Kahraman T, Kalemci O, Sengul YS. Gender differences in postural control in people with nonspecific chronic low back pain. Gait Posture. 2018;64:147–51.
- Tarabeih N, Kalinkovich A, Shalata A, Cherny SS, Livshits G. Deciphering the Causal Relationships Between Low Back Pain Complications, Metabolic Factors, and Comorbidities. J Pain Res. 2022;15:215–27. Chandanwale et al / Indian Journal of Orthopaedics Surgery 2025;11(2):122–129 129
- Andersson HI, Leden I. Increased serum uric acid--a marker of non- gouty widespread pain? A study of female patients with inflammatory and non-inflammatory pain. Scand J Rheumatol. 2006;35(4):261–7.
- Kim SK, Jung UH, Choe JY. Clinical usefulness of uric acid as a biomarker for knee osteoarthritis: a comparative analysis with plain radiography and musculoskeletal ultrasound. J Rheum Dis. 2020;27(1):51–60.
- Harrisson SA, Stynes S, Dunn KM, Foster NE, Konstantinou K. Neuropathic pain in low back-related leg pain patients: what is the evidence of prevalence, characteristics, and prognosis in primary care? A systematic review of the literature. J Pain. 2017;18(11):1295–312.
- Bunzli S, Smith A, Schütze R, O'Sullivan P. Beliefs underlying pain- related fear and how they evolve: a qualitative investigation in people with chronic back pain and high pain-related fear. BMJ Open. 2015;5(10):e008847.
- Amila A, Syapitri H, Sembiring E. The effect of William flexion exercise on reducing pain intensity for elderly with low back pain. Int J Nurs Health Serv. 2021;4(1):28-36.
- Palsson TS, Christensen SW, De Martino E, Graven-Nielsen T. Pain and disability in low back pain can be reduced despite no significant improvements in mechanistic pain biomarkers. Clin J Pain. 2021;37(5):330–8.
- Stevans JM, Delitto A, Khoja SS, Patterson CG, Smith CN, Schneider MJ, et al. Risk Factors Associated With Transition From Acute to Chronic Low Back Pain in US Patients Seeking Primary Care. JAMA Netw Open. 2021;4(2):e2037371.
- Wernli K, O'Sullivan P, Smith A, Campbell A, Kent P. Movement, posture and low back pain. How do they relate? A replicated single- case design in 12 people with persistent, disabling low back pain. Eur J Pain. 2020;24(9):1831–49.
- Thiry P, Houry M, Philippe L, Nocent O, Buisseret F, Dierick F, et al. Machine learning identifies chronic low back pain patients from an instrumented trunk bending and return test. Sensors. 2022;22(13):5027.
- Zhang Y, Song J, Lin W, Ding L. Transforaminal endoscopic lumbar discectomy with two-segment foraminoplasty for the treatment of very highly migrated lumbar disc herniation: a retrospective analysis. BMC Surg. 2024;24(1):1–2.
- He S, Zhang Y, Ji W, Liu H, He F, Chen A, et al. Analysis of Spinopelvic Sagittal Balance and Persistent Low Back Pain (PLBP) for Degenerative Spondylolisthesis (DS) following Posterior Lumbar Interbody Fusion (PLIF). Pain Res Manag. 2020:5971937.
- Yuan JJ, Li G, Liu Y, Zhang Q, Ren ZS, Tian R. The association between sagittal spinopelvic alignment and persistent low back pain after posterior lumbar interbody fusion for treatment of mild L5-S1 Spondylolisthesis: A retrospective study. Int J Gen Med. 2022;15:4807–16.
- Du SH, Zhang YH, Yang QH, Wang YC, Fang Y, Wang XQ. Spinal posture assessment and low back pain. EFORT Open Rev. 2023;8(9):708–18.
- Lee SH, Lim CW, Choi KY, Jo S. Effect of spine-pelvis relationship in total hip arthroplasty. Hip Pelvis. 2019;31(1):4–10.
- Rahyussalim AJ, Zufar MLL, Kurniawati T. Significance of the Association between Disc Degeneration Changes on Imaging and Low Back Pain: A Review Article. Asian Spine J. 2020;14(2):245–
- Urits I, Burshtein A, Sharma M, Testa L, Gold PA, Orhurhu V, et al. Low back pain, a comprehensive review: pathophysiology, diagnosis, and treatment. Curr Pain Headache Rep. 2019;23(3):23.
- Alam MF, Ansari S, Zaki S, Sharma S, Nuhmani S, Alnagmoosh A, et al. Effects of physical interventions on pain and disability in chronic low back pain with pronated feet: a systematic review and meta-analysis. Physiother Theory Pract. 2025;41(2):390–404.
- Daniels SP, Feinberg JH, Carrino JA, Behzadi AH, Sneag DB. MRI of foot drop: how we do it. Radiology. 2018;289(1):9–24.
- Rogers J, Jones G, Cook JL, Wills K, Lahham A, Winzenberg TM. Chronic Plantar Heel Pain Is Principally Associated With Waist Girth (Systemic) and Pain (Central) Factors, Not Foot Factors: A Case-Control Study. J Orthop Sports Phys Ther. 2021;51(9):449–
- Richie DH, Rosenbloom KB. Pathomechanics of common foot disorders. Cham, Switzerland: Springer; 2021.
- Lee W, Metgud N, Moore M. Association of obesity and plantar fasciitis in patients with plantar heel spurs. Foot Ankle Orthop. 2023;8(4):24730114231213625.
- Shiri R, Falah-Hassani K, Heliövaara M, Solovieva S, Amiri S, Lallukka T, et al. Risk factors for low back pain: A population-based longitudinal study. Arthritis Care Res (Hoboken). 2019;71(2):290–
- Trouvin A, Perrot S. New concepts of pain. Best Pract Res Clin Rheumatol. 2019;33(3):101415.