June 20

The Causal Effect of the Feet to Lower Back Pain and Hyperhidrosis

So last week, my family visited me.  Being a podiatrist, I usually would get questions from people regarding their feet and the pressing issues that they are experiencing.  So on this particular visit, a question was raised on how to treat the excessive sweating and odor to one’s feet.  Well, the parents of the nephew raised the issue and would like suggestions to treat this condition, for this condition affects all who have to smell the foot odor after the nephew’s baseball game.  It is bad enough that the house would smell like a locker room.

Well, the malodor of the feet comes from the breakdown of the bacteria and fungal presence in the sweaty feet, a medical condition called hyperhidrosis.  For this particular condition, I suggested soaking the feet once a week in Epsom salt to clear the bacteria and fungus burden to the feet.  This regimen should be coupled with the use of an anti-perspirant medicated pad or spray to the feet, i.e. Bromi lotion or Certain Dri, to keep the feet dry.  If the moisture is controlled, the malodor will resolve.  (The Bromi lotion is sold at my office.)

An interesting observation that occurred with the family visit is that I noticed another nephew stretching his calves frequently and I asked him for a reason.  He relates that he has two issues, tight muscle groups and chronic lower back pain.  This particular nephew is very active in sports and in college.  The more he does, the symptoms worsen.  He has to constantly stretch and pays frequent visits, every other week, to the chiropractor for adjustment and massage to relieve his lower back pain.  He has no past injury to his joints or known spinal disorder, yet he suffers greatly.

A light bulb came on, and I asked to examine his feet.  In my examination, my findings included the tightness of his muscle groups, especially to his calf muscles, and the extremely high arch foot type.  In medical school, we were taught that a cavus foot type, or high arch foot type, could lead to many symptoms including foot, ankle, shin splints, knee pain and lower back pain.  While he doesn’t have foot pain, he has knee and lower back pain frequently.  My assessment is that his lower back pain is due to his foot biomechanics and equinus, the tightness of his calves. I recommend that he chooses supportive shoes with extra shock absorption, and I made him custom orthotics to support his feet and to minimize shock that could translate proximally to his knees and lower back.  Of course, I outlined an aggressive stretching regimen for this tight muscle group.  These steps that I have implemented will prevent him from the frequent, unnecessary visits to his chiropractor.

The take home point is that the foot structure and foot type could have a direct link to lower back pain.  A thorough history and foot exam can reveal the condition.  Most people do not realize the relationship of the foot structure to its effect on the kinetic chain that go up to the proximal joints.  When in doubt, talk to your podiatrist about your symptoms and have a foot exam to rule out this cause and effect of the feet to the lower back.

Dr. Dang H. Vu, DPM is a Baltimore Podiatrist with more than 15 years of experience. He completed his residency at Sinai Hospital of Baltimore, where he furthered his surgical expertise. He now holds privileges at Northwest Hospital. He offers services from three Baltimore Locations in Reisterstown, Towson and in the Rotunda Building in Hampden. You can find directions and request an appointment on his website FamilyPodiatryofMD.com


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