Back pain can very often be related to foot function. When foot biomechanical factors lead to excessive internal rotation of the Femur, the resulting change of pelvic position can greatly increase the strain on the lower lumbar vertebrae, which can lead to an increase in the amount of pain experienced in the back. Following careful and complete biomechanical assessment of the feet, prescription foot orthotic therapy can become an important stabilizing component of treatment for lower back pain. The addition of prescription foot orthotics to the management of lower back pain related to other causes, can help to assist in better pain management, with resulting improvements in long term outcomes.