How Your Feet Are Causing Your Back Pain – And What Custom Orthotics Can Do About It

By Dr. Todd A. Whittemore, D.C.  |  Published March 24, 2026

Here's something most people never get told: if your lower back, hip, or knee pain keeps coming back no matter what you do for it, the problem might not actually be where it hurts.

It might be where you stand.

This is one of the most consistently missed pieces of the puzzle in recurring musculoskeletal pain — and it's something Dr. Todd evaluates in every patient who keeps cycling through the same problem. Patients from Acton, Sudbury, Maynard, Hudson, and across MetroWest Boston come in having been adjusted, stretched, strengthened, and injected — and the same thing keeps coming back. Often, the reason is sitting right underneath them.

Why Do Your Feet Have Anything to Do With Your Back?

Your spine doesn't float. It sits on top of your pelvis, which connects to your hips, which connect to your knees, which connect to your feet. Every single step you take sends force upward through that entire chain. When the foundation is off — even slightly — everything above it has to compensate.

Your foot contains 26 bones, 33 joints, and over 100 muscles, tendons, and ligaments. It also has three distinct arches: the medial arch along the inside of the foot, the lateral arch along the outside, and the transverse arch across the ball of the foot. Together, these arches are designed to absorb shock, distribute weight evenly, and propel you forward with each step.

When one or more arches collapse — or when one foot loads differently than the other — that asymmetry travels straight up the kinetic chain. The ankle rolls slightly. The knee tracks inward. The hip rotates to compensate. The pelvis tilts. And the lumbar spine, trying to keep your eyes level with the horizon, twists and compresses to absorb an imbalance it was never designed to handle 8,000 steps a day.

That's the structural root cause most people never get shown.

Why Do Chiropractic Adjustments Help But Not Fully Stick for Some Patients?

This is the question that leads a lot of patients to the orthotics conversation. Adjustments restore motion to restricted spinal joints — they work. But if you walk out of the office and spend the rest of your day loading your spine unevenly because of what's happening at your feet, your body keeps getting pulled back out of alignment between visits.

Think of it like a wheel alignment on your car. The mechanic aligns the wheels perfectly — but if there's a bent component in the suspension causing the pull, the alignment won't hold. You'll be back in a few weeks with the same problem.

Chiropractic adjustments and custom orthotics work best together. Adjustments restore motion and reduce mechanical stress in the spine. Orthotics stabilize the base so the spine doesn't keep getting dragged back into the same compensatory pattern between visits. Patients who add orthotics often notice that their adjustments hold longer — and that the overall trajectory of their improvement accelerates.

What's the Difference Between Custom Orthotics and the Insoles at the Running Store?

This comes up constantly — especially with runners and active adults who've already tried Superfeet, Spenco, or whatever the running store recommended. Those insoles can improve comfort. But comfort isn't structural correction.

Here's the core difference. Over-the-counter insoles are mass-produced. They're designed around broad foot-type categories, they primarily support the medial arch (the big inside arch), and they're identical on both feet. Your left and right foot, however, are almost never mirror images of each other. Most people have measurably different arch patterns, weight distribution, and load mechanics on each side.

Foot Levelers custom orthotics are different in three important ways. First, they're fabricated from a digital scan of your individual feet — not a generic mold. Second, they're engineered to support all three arches simultaneously, not just the medial one. Supporting only one arch while ignoring the other two is like propping up one corner of a table — the rest still wobbles. Third, each orthotic is built specifically for that foot, so the left and right address each foot's unique structural profile independently.

The result isn't just cushioning. It's correction — stabilizing the entire base of the kinetic chain and reducing the compensatory strain that travels up into the knees, hips, and spine.

Who Actually Benefits From Custom Orthotics? (It's Not Just Seniors)

One of the most persistent myths about orthotics is that they're for elderly people with serious foot problems. In reality, some of the patients who benefit most are active adults in their 30s, 40s, and 50s who have no obvious foot pain at all — but who have recurring pain further up the chain that no one has connected back to foot mechanics.

We regularly see runners, golfers, desk workers, and people who stand all day on hard floors — from Concord, Bolton, Boxborough, Marlborough, and across MetroWest Boston — who've been managing recurring knee, hip, or low back pain for years without anyone ever looking at their feet.

One patient's testimonial says it better than we could: "I've been a runner for over 25 years. I feared those days were over when I stumbled into Dr. Todd's office with substantial lower back and hip pain. He got me straightened out literally. He showed me my issues were caused by poor alignment and being out of balance. He got me the right inserts for my shoes and the right pillow to use. A few weeks later I'm feeling great and running and golfing without pain."

Twenty-five years of running, and the answer turned out to be in his shoes.

What Is a Stabilizing Orthotic Scan — and Why Is It Free?

The free stabilizing orthotic scan is exactly what it sounds like. We use a digital scanner to capture the structural profile of each foot — arch height, weight distribution, load patterns — and show you in plain language what's happening at your foundation and how it may be connecting to symptoms you've been feeling higher up.

There's no obligation to purchase orthotics. The scan is offered because a lot of patients genuinely don't know this piece of the picture exists, and we'd rather show you something useful than have you keep cycling through the same pain without understanding why. If orthotics make sense for your situation, Dr. Todd will tell you. If they don't, he'll tell you that too.

It takes about 10 minutes and occasionally changes the entire direction of a patient's care.

Your Back Pain Might Have a Foundation Problem — Here's How to Find Out

If you've been treating your back, hip, or knee pain without lasting results, and nobody has ever evaluated your foot mechanics, that's the missing piece worth looking at. Dr. Todd and Dr. Ryan see patients from Stow, Harvard, Maynard, Hudson, and across MetroWest Boston who've been through rounds of treatment without anyone connecting the dots from foot to spine. The free orthotic scan is a low-commitment way to find out if your foundation is part of the story. Details on what to expect at your first appointments are on the New Patient Visit page.

You've read this far — which means you're ready to actually solve the problem rather than manage it. Let's do that.