Sagittal plane blockage of the foot, ankle and hallux and foot alignment-prevalence and association with low back pain

IntroductionSome practitioners believe mechanical low back pain may be caused or aggravated by a stiff ankle, stiff great toe or flat feet. This study investigates subjects with and without mechanical low back pain and measures ankle and great toe range of motion and flattening of the medial longitudinal arch in both groups.MethodsThe study was a blinded, 2-arm, non- randomized clinical study involving 100 subjects with chronic or recurrent mechanical low back pain (intervention group) and 104 subjects without chronic mechanical low back pain (control group) between the ages of 18 and 45. A blind assessor performed weight-bearing goniometry of the ankle and big toe and the navicular drop test on all subjects in both groups.ResultsAn independent t-test (inter-group) revealed a statistically significant decrease (p ≤ 0.05) in ankle dorsiflexion range of motion in individuals with chronic mechanical low back pain. The independent t-test suggested individuals with chronic mechanical low back pain have a significantly smaller navicular drop and higher arches (p < 0.05).ConclusionThis study supports previous reports suggesting decreased ankle dorsiflexion may be a factor in chronic mechanical low-back pain. Further research and replication of this study is necessary before firm conclusions or recommendations can be made.