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When prescribing foot orthotics, it is important to be aware of how other parts of the body may be affected. This is one reason why a team approach with podiatrists consulting with orthopedists can better help our patients. 

One common example we all probably know about is that with limited dorsiflexion of the foot on the leg, a heel lifts can be effective in preventing that anterior pelvic tilt and arching of the back which can result in back pain. 

1. My question is what type of shoe or orthotic modifications are helpful when a hypothetical patient with scoliosis has lumbar foraminal stenosis on the right side worse than the left side, at various levels of the lower back? 

  • Comments (2)
  • I don't understand how a scoliosis creates a limb length discrepancy.   If the top of the talus is the same height off of the ground for both sides.  The tibia and femur are the same length.   How would a scoliosis create a limb length discrepancy?

  • Dan - scoliosis is a curvature of the spine as you well know. The curvature can be responsible for a limb length discrepancy created by the curvature.
    So, like any other LLD a heel lift on the shorter side can help rebalance assuming the discrepancy is carried into the lower extremity. The lift or the orthotic will do absolutely nothing to help the actual foraminal stenosis. Afterall, how could an orthotic increase the canal, and decrease the nerve impingement...?