#leg length difference

 A few signs that your feet may be contributing to your pain:

Your low back feels worse in less supportive shoes such as flip flops

You feel worse walking bare foot, walking long distances or with prolonged standing. 

 Feet are the foundation of your body and play an important role in absorbing shock when you walk and run.  Because the joints in the lower limb are so closely connected and affect one another, problems with the mechanics of the foot can transfer up the legs and into the low back. 

One of the actions of the foot that is important to look at is pronation.  Pronation (basically the arches lowering) is a normal part of walking and is fundamental in shock absorption.  Problems arise when there is too much pronation.  This means that the arches are collapsing excessively.  This causes the lower leg and thigh to inwardly rotate too much, the knees to hyperextend and turn in, the pelvis to tilt forward and the curvature of the low back to increase.  In order to address these issues, orthotics can be used to support and restore the arch of the foot, thereby improving body posture up the chain.  As this occurs, the tension and stress on the lower back muscles is decreased and the associated pain and tiredness is relieved. 

If the collapsing of the arch occurs on only one side, it can cause a false leg length difference because the poor mechanics of the foot causes the leg to shorten. In order to correct this difference, orthotics can be used to support and correct the arch height on the collapsed side and maintain the neutral positioning on the opposite side.  In the case of a true leg length difference, a lift should be put under the shorter limb.