Arch enemy: Flat feet and sciatica pain

Flat feet, also known as pes planus, can cause pain and nerve pressure issues elsewhere in your body. One such place is the Sciatic area – your lower spine, and back of the leg.

With a flat foot, the arch is “collapsed”, causing your sole to come into contact with the ground. This is often a problem – causing chronic pain in the ankle and knee, and messing with your hip alignment.

Let’s explore this connection between fallen arches and sciatica, and how to tell if your sciatica originates in the foot.

Can flat feet cause sciatica pain?

Yes, flat feet (pes planus) can cause sciatica pain by making a chronic twist at the hip and knee, affecting the pelvis and lumbar spine. Bio-mechanical stress in your lower leg can transmit upward, to place tension or pressure on your sciatic nerve, causing low back pain and sciatica.

The arch of the foot plays a crucial role in the human body – they are like shock absorbers, providing support and stability in the lower legs. When the arch collapses in flat feet, it can cause the heel to rotate inward, leading to overpronation.

This results in the muscles and tendons in the leg and foot to compensate for the lack of support from the arch, leading to overuse problems.

The piriformis muscle and the plantar fascia, which runs along the bottom of the foot, are particularly affected by this overuse.

The result is often inflammation and pain that requires thorough, professional attention.

Causes of a flat foot

Flat feet can be caused by several factors, including

• genetics
• injury
• arthritis
• weakness of lower leg muscles
• lack of proprioception (your sense of joint position awareness)
• overuse

Flat feet can also develop as a result of pregnancy, obesity, or other conditions that put added pressure on the feet.

High heels can also cause flat feet by altering the natural position of your foot and causing damage to the arch over time.

Joint pain and your flat feet

Flat feet can lead to big problems – like joint pain in the knee, hip, and lower spine. This pain is caused by the abnormal alignment of the joints compensating for the collapse of the arch.

The knee joint, in particular, is affected by flat feet as the knee is forced to rotate awkwardly from the lack of foot stability. This can lead to a painful clicking knee, chronic knee pain, increased risk of ACL and MCL injuries, and even knee joint damage (OA) in advanced cases.

Piriformis syndrome from flat feet

Piriformis syndrome arises when your piriformis – a small muscle located deep in the glutes – compresses the sciatic nerve which passes underneath it. This can lead to pain and numbness in the buttocks and down the legs.

Flat feet can contribute to the development of piriformis syndrome as the overuse and strain on the piriformis muscle builds up. This is from having to compensate by becoming tight, irritating the nearby sciatic nerve.

Sciatica, in this way, can lead indirectly to a stressed knee joint, causing new issues.

Physical therapy, stretching, and strengthening exercises are required to alleviate symptoms, and prevent future piriformis syndrome caused by flat feet.

Will arch support help sciatica?

Arch support is a simple and effective approach to start fixing sciatica that is being aggravated by flat feet. This works by reducing overpronation, the collapse of the main arch, and the strain on the muscles and tendons in your leg and foot.

As tension comes off the sciatic nerve, inflammation and pain subside, which are some of the 12 signs of nerve healing. Custom orthotics, which are designed to support the arch of the foot, can be particularly effective in treating sciatica pain caused by flat feet.

Wearing supportive shoes with good arch support can also help alleviate symptoms. However, it’s best consulting with a healthcare professional to find the best product for you.

Treating Sciatica Pain from Flat Feet

Treatment options for flat feet-related sciatica pain include

• physical therapy
• custom orthotics
• supportive shoes
• chiropractic care

Physical therapy can help to strengthen the muscles and tendons in the leg and foot, reducing the strain on the sciatic nerve. One important tendon to know about is the posterior tibial tendon, which runs from your lower leg down to the inside arch of your foot.

The posterior tibial tendon is a key player in the arch support system in your foot. Its main function is to help maintain and stabilize your main arch, allowing for proper posture and alignment when standing, walking, or running.

A Physical therapist will help you strengthen this muscle to improve your flat foot. Here is a great video about this from E3 Rehab:

A newer treatment for sciatica and related issues is dry needling – a close relative of acupuncture.

Some people turn to compression therapies as a home remedy that may reduce some of the discomfort from sciatica pain.

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TENS pad placement for Sciatica

Custom orthotics can be used to support the arch of the foot and reduce overpronation of your talus bone, and support the navicular bone which is “dropped”. Supportive shoes with good arch support may reduce the strain on your sciatic nerve, so ask your podiatrist for the best shoe brand for your lower-leg biomechanics.

Chiropractic care is an excellent way to approach sciatica pain caused by flat feet. A chiropractor aims to reduce pain, improve posture and mobility, and prevent future injuries and degeneration in your spine.

Simply arrange a consult and follow a recommended treatment plan to achieve the best results. Most chiropractors work with sciatica patients regularly. Most sciatica cases arise from herniated lumbar discs, bone spurs in the lumbar vertebrae, and other degenerative problems in your low back that cause nerve root pressure.

Sometimes, x-ray films of your lower back can shed light on the health of your spine and sciatic nerve roots. For this problem, however, you’ll likely need something more advanced.

Imaging for flat-foot sciatic pain

MRI scans or CT scans provide a more detailed look at a herniated disc or spinal stenosis. It’s important to get the full picture to achieve pain relief and avoid dangerous long-term effects of nerve compression – like peripheral neuropathy.

Peripheral neuropathy is a kind of nerve damage that can happen when the nerves in your body don’t work properly. This can cause pain and other symptoms like feeling weak or numb.

You definitely want to avoid this outcome – so make sure you get your flat feet and sciatica checked today! Ask us below in the comments if you’re unsure what to do next.