Back Pain Relief

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Q. I suffer from lower back pain and have heard that wearing Crocs™ can help reduce the pain. Is this true? Can particular types of shoes help reduce pain? Do ergonomic desks and chairs really reduce back pain?

A. While there are no scientifically proven studies to show that a specific brand of shoe reduces back pain, I have known patients who felt symptom improvement after a switch to a certain type of shoe (Crocs™, Rockports, Easy Spirits, others). While I don't know the exact reason, perhaps it was because they purchased a flat shoe that fits properly and also provided cushioned support for their heel, arch, and toes.

The best way to reduce your pain is to find the cause. If it’s from a leg length imbalance, perhaps a shoe lift would help. If it’s from prolonged sitting, an adjustable chair providing lumbar support in combination with periodic stretching, standing and walking may ease the pain. If that type of chair is not available, then a height-adjustable desk may enable a better seated position. However, before purchasing a specific type of shoe or ergonomic device, visit your personal physician to ensure you are getting the help you need.

As you know if you've ever owned a pair of ill-fitting shoes, when your feet are not happy, other health issues may follow (headaches, irritability, limited mobility, etc.). And while we may attempt to carry on in spite of foot pain, our body compensates by walking with an altered stride. This in turn has the potential to trigger ankle, knee, hip, and back pain.

Before you shop for shoes

Because the way your shoes fit affects other body systems, it's especially important to make the right choices when shopping for shoes. Before you slide into your next pair of shoes, keep these ideas in mind to reduce “the agony of da-feet:”

Shop for shoes at the end of the day. This is generally when your feet are at their greatest size, often due to excess fluid from the effects of gravity.
Ask to get your foot size measured, as there may have been a change in length or width. If one foot is bigger than the other, fit the shoe to the largest foot.
Wear the type of socks you would use with that particular shoe.
If you wear an orthotic device, place it in your new shoe to ensure proper fit.
If you have a foot health concern (bunions, blisters, high arch or flat feet), discuss with your foot specialist (podiatrist) for suggestions.
If purchasing women’s shoes, aim for flats. If heels are a must, limit the elevation to an inch.
Try on both shoes and walk around to ensure a comfortable fit. No matter what the size, if it hurts inside the store, it will hurt later. There's no “break-in” period when it comes to shoes.
Buy the shoe to match the activity. For instance, while running shoes are engineered to accommodate and absorb heel strikes to the ground, tennis shoes provide greater side-to-side stability.
Aim for a half an inch of wiggle room from the end of your large toe to the end of the shoe. It’s also important to ensure comfort and fit in the heel area. If it's too tight or offers little or no cushion, walk away from that particular shoe.

Work the desk and chair angle

For those of us who spend hours at a work desk, the next priority in solving back pain problems should focus on how comfortable we are at our desks and chairs. When it comes to ergonomic chairs and desks, one size does not fit all—each person is different, just like the various ergonomic devices. Plus, there's no guarantee they will relieve back pain. The key is finding a chair, desk and seating position that allows for comfortable personalized adjustments. Important considerations include the following:

Find the size seat cushion that accommodates your bottom.
Check to be sure you have a seat back that allows for upright to slightly reclining levels of positioning.
Get the best lumbar support available to you.
Make sure you have the ability to move up or down, allowing your feet to comfortably rest on the floor.
Check the chair's ability to swivel and rotate from side to side.

It is also important to find a workstation that offers easy access to your computer, screen, keyboard, phone and other equipment you frequently use without eye, neck, arm or leg strain. The surface of the desk may have the ability to tilt toward the user, as well as move up or down. There are also workstations designed for mobility and use in the standing position. However, just like shoes, it is best to try these ergonomic devices before purchase to ensure they provide the help you need.

Lastly, no matter how comfortable the chair or how ergonomically perfect the workstation, prolonged sitting increases the potential for back discomfort and pain.

For further information, please see my article on Sitting in Pain.

Also, check out the Web sites of the American Podiatric Medical Association and the American Physical Therapy Association.

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Robert Danoff, D.O., M.S., is a family physician and program director of The Family Practice Residency, as well as the combined Family Practice/Emergency Medicine Residency programs at Frankford Hospitals, Jefferson Health System, Philadelphia, Pa. He is the medical correspondent for CN8, The Comcast Network, a regular contributor to Discovery Health Online and a contributing writer to The New York Times Special Features. (Read his full bio.)