Because Dr. Hannan is Editor of Arthritis Care & Research, review of this article was handled by the Editor of Arthritis & Rheumatism.
Lower Extremity Pain
Associations of Foot Posture and Function to Lower Extremity Pain: Results From a Population-Based Foot Study
Article first published online: 28 OCT 2013
Copyright © 2013 by the American College of Rheumatology
Arthritis Care & Research
Volume 65, Issue 11, pages 1804–1812, November 2013
How to Cite
Riskowski, J. L., Dufour, A. B., Hagedorn, T. J., Hillstrom, H. J., Casey, V. A. and Hannan, M. T. (2013), Associations of Foot Posture and Function to Lower Extremity Pain: Results From a Population-Based Foot Study. Arthritis Care Res, 65: 1804–1812. doi: 10.1002/acr.22049
- Issue published online: 28 OCT 2013
- Article first published online: 28 OCT 2013
- Accepted manuscript online: 5 JUN 2013 09:18AM EST
- Manuscript Accepted: 16 MAY 2013
- Manuscript Received: 27 DEC 2012
- NIH/National Institute of Arthritis and Musculoskeletal and Skin Diseases. Grant Number: R01-AR-047853
Studies have implicated foot posture and foot function as risk factors for lower extremity pain. Empirical population-based evidence for this assertion is lacking; therefore, the purpose of this study was to evaluate cross-sectional associations of foot posture and foot function to lower extremity joint pain in a population-based study of adults.
Participants were members of the Framingham Foot Study. Lower extremity joint pain was determined by the response to the National Health and Nutrition Examination Survey–type question, “On most days do you have pain, aching or stiffness in your (hips, knees, ankles, or feet)?” The Modified Arch Index classified participants as having planus, rectus (referent), or cavus foot posture. The Center of Pressure Excursion Index classified participants as having overpronated, normal (referent), or oversupinated foot function. Crude and adjusted (age, sex, and body mass index) logistic regression determined associations of foot posture and function to lower extremity pain.
Participants with planus structure had higher odds of knee (odds ratio [OR] 1.57, 95% confidence interval [95% CI] 1.24–1.99) or ankle (OR 1.47, 95% CI 1.05–2.06) pain, whereas those with a cavus foot structure had increased odds of ankle pain only (OR 7.56, 95% CI 1.99–28.8) and pain at 1 lower extremity site (OR 1.37, 95% CI 1.04–1.80). Associations between foot function and lower extremity joint pain were not statistically significant except for a reduced risk of hip pain in those with an oversupinated foot function (OR 0.69, 95% CI 0.51–0.93).
These findings offer a link between foot posture and lower extremity pain, highlighting the need for longitudinal or intervention studies.