Effects of physical interventions on pain and disability in chronic low back pain with pronated feet: a systematic review and meta-analysis

ABSTRACT

Background

A link between pronated feet (PF) and chronic low back pain (CLBP) has been reported in the literature. However, physical interventions (PI) like physiotherapy and orthotics mainly target the lower back, neglecting the broader biomechanical impacts of PF that affect the feet, ankles, and overall posture. Currently, there is a lack of comprehensive meta-analyses or systematic reviews on this subject.

Objectives

This systematic review with a meta-analysis aimed to evaluate the effects of PI on pain and disability in patients having CLBP with PF.

Methods

From inception until October 15, 2023, Medline/PubMed, Web of Science, and Scopus databases were searched using the desired keywords for randomized control trials (RCTs). The quality of the RCTs was evaluated using the PEDro scale and risk of bias tool.

Results

Four studies involving 268 patients were identified, two compared custom-made foot orthoses to non-biomechanical foot insoles, while the other two used exercises. The meta-analysis included four studies for pain and three for disability. The results showed a significant change in pain [−2.43 (95% CI −2.73 to −2.13, p < .001)] and disability of −6.69 (95% CI −8.04 to −5.33, p < .001)].

Conclusions

This systematic review and meta-analysis of four RCTs elucidates that PI, specifically targeting PF, significantly alleviate pain and reduce disability in patients having CLBP with PF. These findings advocate for integrating foot-based PI within the treatment protocols for patients suffering from CLBP accompanied by PF.

KEYWORDS:

• Foot pronation
• posture
• foot orthosis
• exercise
• back pain
• disability

Disclosure statement

No potential conflict of interest was reported by the author(s).

Authors’s Contribution

Conceptualization: MFA (Md Farhan Alam) and SS (Saurabh Sharma); methodology: MFA, SA (Sumbul Ansari), and SZ (Saima Zaki); Formal analysis: MFA and SZ; Supervision, SS, and SN (Shibili Nuhmani); Data curation: MFA and SZ; Writing, original draft preparation: MFA and SZ; Writing review and editing: SS, SN, SZ, AA (Abdullah Alnagmoosh), and MEA (Mohammed Essa Alsubaiei); Visualization: SZ, SN, AA, SA, and MEA. All authors have read and approved the final draft of the manuscript.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.