RJ Burr the authorRJ Burr DC, Cert. MDT, CSCS
Updated: July 18, 2021

Have you ever wondered how your footwear may be affecting your body mechanics, possibly a culprit to your back pain frustrations?

You, of course, have a standing desk, exercise, take the stairs, and so on, all for a healthier, active lifestyle. But you may be proverbially shooting yourself in the foot with your footwear selection, pun specifically intended.

Each of our feet is composed of 26 bones, 33 joints, and over 100 muscles, tendons, and ligaments. The foot is an engineering marvel made this way for a reason: to create and control movement.

Before concrete and flattened, man-made surfaces, our feet were constantly challenged by undulating surfaces keeping them strong, healthy, and functional. In the modern world, it’s not practical to walk around barefoot nor socially accepted in most places. However, modern doesn’t have to compromise natural.

Simply stated, when we cram our feet into tight and narrow footwear, we paralyze our feet from its natural movement, altering the way we function.

Reference the pictures below. When we toe off in our walk, the foot turns into a rigid lever to propel forward (left). When we step forward and land with the other foot into heel strike, the rigid lever then turns into a shock absorber by splaying outward to dissipate force (right).


When your footwear doesn’t allow this occur naturally, those ground ‘n pound forces are transmitted up to the knees, hips, and the low back.

Take a look at the footwear comparison below.


Notice how the shoes on the left have a wider toe box whereas the shoes on the right-side of the pictures have a steep and narrow toe box.

The shoes on the left side allow the foot to do its job, where the shoes on the right side are holding the little piggies back.

So, what can we do about it? You’ve come to right place.

1. Walk outside

Not to mention all the health benefits of being active, walk around the Earth in your bare feet to feel the ground below you. Squeeze the sand between your toes. Spread your toes in the grass and sink them into the sod. Don’t be surprised when your feet are sore from all those little muscles in your feet waking up, having to do some work!

2. Get yourself some barefoot shoes

To be fair, there aren’t a lot of options regarding stylish “bare” footwear (and not exactly the most affordable), and fashion is always changing. However, companies like Vivobarefoot, True Linkswear, Merrell, and Xero Shoes are making a push for form, function, and style.

If your feet are accustomed to the cushy, cosy shod-life, it’s important to test the waters before diving in. Your feet will need some time to get used to the new environment. Also, note barefoot shoes aren’t for everyone. For some individuals, orthotics or a specific type of supportive shoe may be your best bet.

3. Exercise your feet

The best thing you can do for your feet is to use them naturally. Although as mentioned, most of us have sheltered our feet in cushy shoes. A great way to wake up your feet and train them for functional activities and sport is self-mobilization of the foot followed by foot intrinsics exercises below.

Nestle your fingertips between your toes (don’t be surprised if you struggle with this!). Then, actively pull your foot and toes up toward your knee with your foot muscles, assisting with the hand. Next, do the opposite by pointing the foot and toes away from the knee. Repeat this cycle for about 10-20 repetitions to open up the foot.

4. Take your shoes off at work

Most people can get away with popping their shoes off when sitting at their desk, so why not when standing? Unless your employer has ridiculous rules against this or you have personal hygiene issues -- which is a whole other problem in itself -- let your puppies breathe while standing on your SmartCells Anti-Fatigue Mat.

If you’re inclined to exercise at your desk, try this simple single-leg balance exercise to strengthen your feet in conjunction with your entire leg and core, the way the body is meant to function -- as a sum of its parts!

5. Use orthotic inserts or custom insoles

Your shoes may cost as much as several hundred dollars. Have you ever wondered how much thought was put into the factory insoles? Let's be honest - insoles are just an after thought to most manufacturers. The right insoles can help to relieve lower body discomfort including shin splints, knee & joint pain, as well as lower back pain. Make the investment in a pair of custom insoles. It just might be the difference maker when it comes to your back pain. Check out our review of Wiivv's 3D-Printed insoles.


Curb your back, hip, knee, or foot pain frustrations by getting back to the basics of human movement by taking a minimalist approach to your footwear.

Frequently Asked Questions about Footwear and Back Pain

Here are our answers to the most frequently asked questions about footwear and back pain.

Can footwear cause back pain?

Yes. The feet are the foundation of the body and any imbalance due to high arches, low arches, and improper footwear can affect the ankles, knees, hips, lower back, and even the neck.

What shoes are best for lower back pain?

In general, a minimalist approach to footwear is best. However, if you have high arches or fallen arches, you may benefit from insoles or shoes with more support.

Can wearing slippers cause back pain?

For some people, slippers may cause or contribute to back pain. If you need orthotics, slippers almost never provide the support that you may need if you don't have arch support. I

How should I sleep with lower back pain?

For some people with low back pain, sleeping on their stomach exacerbates their pain. This isn't true for all back pain sufferers. Another helpful tip is to sleep with a pillow between the knees.

What shoes do doctors recommend?

Some pediatricians are recommending barefoot shoes, also referred to "minimalist footwear", such as Vivobarefoot, True Linkswear, Merrell, and Xero Shoes. They also often recommend using orthotics.