Southwest Florida Neurosurgical Associates


The Best and Worst Footwear for Your Back

When you think of back pain, do you imagine something related to a sports injury or herniated disc? While these situations often bring patients into the doctor’s office, the pain could come from a less threatening source—your shoes.

Back pain is the number two reason individuals visit their doctors. As this pain represents such a common problem, it shouldn’t surprise you that it stems from something just as ordinary.

The reason lies in the fact that the foot acts as the foundation for the rest of the body. Whatever force you put on your feet ultimately makes its way to the back. Additionally, an issue with your feet can adjust your body’s entire alignment up through the spine. And improper footwear can make pre-existing foot problems even worse.

If you suspect your back problem’s cause rests on your feet, learn about the best and worst shoes below so you can find relief.

Back-Approved Shoe Basics

Before you read about specific shoes, first discover some basic tips that can help you as you search for any shoe.

Remember that your shoe fit contributes to back pain, especially when it comes to arches. You can categorize foot arch into three types: pronated (low arch), neutral, and supinated (high arch). Make sure your arch hugs the shape of the shoe. Good fit will also prevent issues like blisters and squished toes.

You should also look for a flat heel counter (the back part of the shoe) and good shock absorption. These features will keep your foot in a natural shape and reduce the shock that travels up your legs and into your back.

Once you have the basics down, you can narrow your search for good shoes or rid your collection of bad ones.

The Best Footwear Options

Running/Athletic Shoes

These shoes cater to different arch types, so you can find a variety of options that work for your feet. Athletic shoes also have good cushioning and shock absorption to keep your feet comfortable and your lower extremities protected from too much force.

Look for a shoe with a rigid heel and midsole to offer optimal stability. Laces also keep your feet in place to better support you. And since running and athletic shoes have become a large industry, you have lots of options to offer you comfort and style.


Although not a shoe, orthotics often improve the shoes you already own to make them more back-friendly. Orthotics can remedy foot issues that lead to improper gait or posture. The product manipulates foot placement to align the foot and back into a natural position. This realignment can reduce the back pain people associate with long-term improper body posture.

You can purchase either over-the-counter orthotics, like gel inserts, or prescription orthotics. Keep in mind that prescription orthotics can cost upwards of $100, and you may need to replace them as your feet change. However, insurance may cover these costs.

The Worst Footwear Options

Worn Shoes

Your most comfortable pair of running shoes might have offered you support when you first got them. But after a year of errands, races, and hikes, they have likely seen better days.

Even if your shoe fits properly, it can cause back problems if time and activity have worn it down. With less shock absorption and support, worn shoes affect gait and posture. Over time, these small changes have a big influence on your back.

High Heels

Your kitten heels might not cause too many problems, but you can feel strain when you wear sky-high stilettos. High heels come with a host of issues, including blisters, inflammation, swelling, and even hairline fractures.

This footwear affects your back because of the distribution of weight and support. Because a heel places all the weight and stress on the ball of the foot, it leads to misalignment and an altered center of gravity. This misalignment causes the common pain that heel-wearers feel in their lower back.

If you can’t face the thought of eliminating heels from your wardrobe, consider some ways to reduce the affiliated stress. Avoid shoes with a heel taller than two inches. The lower the heel, the closer your foot rests to its natural position.

Additionally, wear heels in moderation. All-day pressure and force can lead to more serious problems.

Ultra-Flat Shoes

In your efforts to reduce high heel pain, don’t resort to the opposite option. Flat shoes, like flips flops or ballet flats, don’t offer a much better solution. Because they provide little to no arch support, they stress your joints. Additionally, these shoes can make foot issues even worse.

If you already have an issue with foot, ankle, or knee stress, the lack of support might further aggravate the problem and spread to your back. Instead, try fitted sandals, which offer the no-hassle approach of sandals and the support of a traditional shoe.


If you have back problems with no clear source, use this information to determine if you could benefit from better shoes. And if you continue to have back pain, or if you want more information, a physician can help. Work with a professional as necessary to keep your back painless and healthy.

Close Menu