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How Shoe Choice Affects Your Back Health 

Feb 14, 2025
How Shoe Choice Affects Your Back Health 
Could your shoe choices impact your back health? Discover how your footwear affects your spinal alignment — and how to choose supportive shoes that reduce or eliminate back pain. 

Your footwear impacts your posture and, in turn, your back health. Too many people wear non-supportive shoes and complain of back pain. However, when you think of your feet as your foundation, you can see they support the rest of your body. Change your shoes, and you just might rid yourself of back pain. 

At Spine & Pain Center of San Antonio in Live Oak and San Antonio, Texas, Dr. Sergio Alvarado and our expert team want to help you feel your best. We evaluate the nature of your back pain symptoms, review any medications, lifestyle habits, and influencing factors like shoe choice, and recommend additional tests and treatments as needed.  

Why spinal alignment is important 

If your feet are your foundation, your head is your “roof,” or crown. How your body aligns between these two positions affects how you feel. If your shoes don’t provide the proper support, you disrupt your spinal alignment. This can lead to pain in your knees, hips, neck, legs, shoulders, and most commonly, the lower back. 

Common shoe problems that result in back pain

There are hundreds of shoe choices. Many of them will throw your back out of alignment and lead to pain, including:

High heels 

Squeezing your feet into Barbie-style stilettos is uncomfortable, and it’s not surprising that they’re a common cause of back pain. High heels tilt your pelvis forward, putting pressure on your lower back. When you wear heels, your body is also constantly working to stay balanced. 

Shoes that lack arch support

Ballet flats, flip flops, and plenty of other shoe styles don’t have proper arch support. 

This creates conditions like overpronation (rolling your foot inward) or supination (outward rolling), which can impact your alignment. While rolling your foot a smidge might not seem like much, it changes your hip alignment, which affects your pelvis and spine. It’s all connected.  

Shoes that lack cushioning 

Hard-soled shoes send the impact of hard surfaces straight through your legs. If you choose shoes without good cushioning, it’s your body that winds up absorbing the shock of concrete and other surfaces. 

Shoes that don’t fit well

Ever wear shoes that are too loose or too tight? They’re not only uncomfortable on your feet, but they can change your gait and cause you to distribute your weight differently — all of which can strain your lower back. You should always wear shoes that fit well

Choose the right footwear to reduce back pain 

Hopefully, you can see how your footwear choices impact your musculoskeletal health, including your back. Use the following guidelines to choose better, more supportive shoes: 

Low heels

If you choose heels, make sure they’re less than two inches tall. This lower height will help you maintain normal pelvic alignment.

Arch support and proper fit

Shoes with arch support reduce back strain; when they fit you well, they’ll be comfortable and help your posture.

Replace worn-out shoes 

If you’re a regular runner or walker, your shoe support wears out after six to 12 months. If your shoes wear out, your feet and back aren’t getting the support they need. Replace your shoes as needed to prevent back pain.  

Your partner in back pain relief and prevention

People don’t always link their shoe choices to back pain, but it’s a common cause. If you’re suffering from back pain, we can help. Call or click online to make an appointment at your nearest Spine & Pain Center of San Antonio office in San Antonio or Live Oak, Texas, today.