Flat Feet and Lower Back Pain: What's the Connection?

Flat Feet and Lower Back Pain: What's the Connection?

Americans are no strangers to lower back pain — nearly 65 million people report recent back pain and 16 million experience chronic back pain that places considerable limits on their lives. While there are many roads to lower back pain, it’s worth taking a closer look at your feet to determine whether they contribute to the problem.

To better explain the connection between problems like flat feet and lower back pain, the team here at Annapolis Foot and Ankle Center, led by Dr. Eric Harmelin and Dr. Rikhil Patel, offers the following information.

Understanding flat feet

While children can have flat feet, we’re going to focus on adult-acquired flat feet, which can occur for several different reasons, including:

Tendon issues

The most common cause of flat feet in adults is posterior tibial tendon dysfunction. This tendon travels down your calf and inside your foot where it supports the arches in your feet. When this tendon isn’t functioning well, it can lead to the collapse of your arches.


Inflammatory forms of arthritis, namely rheumatoid arthritis, can attack supportive ligaments in your feet, causing arch collapse.


People who have diabetes can develop flat feet due to nerve damage in their lower limbs.

In addition to the above, an injury can also lead to flat feet or your arches may simply begin to weaken with age, causing your feet to become increasingly flatter.

The connection to your lower back

Flat feet don’t always lead to discomfort, but when they do, that discomfort can stretch from your feet up to your lower back, causing pain in your ankles, knees, and hips along the way.

The reason for this is that your body relies on balance and alignment for pain-free function, and it all starts in your all-important feet. When you stand and your feet are well supported by healthy arches, it encourages proper alignment in your legs. 

When your legs are aligned, your hips are aligned, and your spine sits, stress-free, on these balanced lower structures.

When you have flat feet, your arches collapse and your ankles can roll inward. This upsets the alignment up through your legs and into your hips and lower back, which can lead to joint pain and muscle strain in your lower back as your body compensates for the misalignments.

Treating flat feet (and your lower back pain)

If you suspect your chronic lower back pain may be related to your flat feet, we can often remedy the problem at the source. One of our frontline treatments is to ensure that your footwear is providing the extra support your feet need if the arches aren’t doing the work.

If your footwear falls short, we can outfit you with custom orthotics that rebalance your feet. Once we check that your arches are properly supported, we also recommend physical therapy that can help to re-establish support for your arches.

While surgery is rarely called for when it comes to flat feet, in severe cases, this approach may be the best solution.

To find out if your back pain is connected to your flat feet, come see us for an evaluation. To get started, contact one of our three offices in Annapolis, Stevensville, or Glen Burnie, Maryland, to set up an appointment.

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