Background Lower back pain (LBP) is a leading cause of disability worldwide, with multifactorial etiology making it challenging to treat. Flatfoot is an often overlooked condition that might significantly contribute to the LBP burden.

Objective The primary objective is to establish flat foot as a risk factor for LBP. The study aims to determine the prevalence of flatfoot in patients with LBP compared to those without.

Methods This study was conducted at a private clinic in Chicago who were randomly selected and screened for flatfoot and LBP. The prevalence of flatfoot among patients with LBP was measured, and the odds ratio was calculated.

Results Out of the patients with LBP, 27.3% had flatfoot, compared to only 9.5% among those without LBP. The study found that patients with LBP were 3.54 times more likely to have flatfoot. This association was particularly strong in non-obese, male patients over sixty years of age.

Conclusion The study suggests that flatfoot is a risk factor for LBP. This finding calls for a change in the approach to LBP assessment, including early screening and treatment of asymptomatic flatfoot to prevent complications later in life.

The authors have declared no competing interest.

This study did not receive any funding

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

This study has been approved by the Institutional Ethics Committee of Kempegowda Insititue of Medical Sciences.

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

All data produced in the present study are available upon reasonable request to the authors