How to Choose Shoes That Ease Foot, Knee, and Back Pain

Over the years of helping people navigate chronic pain, one question that comes up again and again is: "What kind of shoes should I be wearing to help reduce my pain?"

I used to recommend specific brands, but I quickly learned that styles change, manufacturing shifts, and what works one season might disappear the next. So instead of chasing the perfect brand, I want to give you a solid understanding of what to look for—so you can shop for shoes with clarity and confidence, no matter what’s on the shelf.

Here’s how to think about shoes that support not just your feet, but your knees, back, and entire sense of balance.

Getting Started: Find shoes that allow your whole foot to rest naturally

The ideal shoe allows your feet to rest naturally without lifting or scrunching any part of it. Look for protection from the elements and light cushioning from hard surfaces (since, let’s face it, we’re not exactly walking on soft pine needles or mossy forest floors these days). Beyond that, it should basically disappear —supporting you without getting in the way. There’s a growing body of research on how footwear design impacts gait. Several studies, including this critical review in Healthcare, emphasize the benefits of minimal footwear.

The Weight Test: Stand Still and Listen to Your Body

When you stand in a shoe, your weight should feel evenly distributed across your foot—from heel to forefoot and between the inside and outside edges. If you feel like you're pitching forward, or if parts of your foot are hovering or jammed, the shoe may be interfering. 

4 Shoe Features to Avoid for knee and back pain Relief:

1. Front End Curved up (Toe Spring)

Many sneakers today have a curved-up front end. Shoe companies say this design supports the “roll-off” motion of walking, but I see it as over-engineering that does more harm than good. Instead of forcing your foot to roll forward, the sole should be flexible enough to follow your foot’s natural motion. When your toes are lifted even when you're standing still, it trains your body into a constant state of tension. Over time, this can compress the transverse arch—the one that runs across the balls of your feet from the big toe to the pinky toe.

Research published by Harvard evolutionary biologist Daniel E. Lieberman and colleagues found that excessive toe spring reduces the power exerted by foot muscles during walking, potentially weakening them over time and increasing susceptibility to conditions like plantar fasciitis and increasing strain on other joints, like your knees and hips.

Pro Tip: While most people are only aware of the inner (medial) arch, your foot actually has three arches—medial, lateral, and transverse—and together they form the dynamic, weight-bearing architecture that helps you balance, move, and stand with ease.

👉 Want to learn more about the arches of your feet? Try this brief foot mediation. You will be surprised at how becoming aware of your arches can be the first step in moving towards greater ease in your body.

2. Narrow Toe Boxes

The toe box is the front part of the shoe where your toes go. Shoes should give your toes room to spread. This helps your foot act as a dynamic, responsive base of support—one that can adjust and adapt as you move.

A narrow toe box often forces the fourth and fifth toes to crowd in toward the big toe. We don’t often think about our pinky toes—until we stub them—but they’re crucial for accessing the lateral arch of your foot (the one that runs alongside your outer ankle) which provides stability and support. When your lateral arch is compromised, it can cause your foot and leg bones to spiral inward, collapsing your weight onto the inner edges of your feet and potentially leading to knee and back pain. 

In her article on Why Foot Biomechanics Matter, Dr. Courtney Conley explores how toe splay is important for maintaining postural balance and foot biomechanics like reducing pressure on the medial (inner) side of the foot—key for preventing knee pain. 

If you have wide feet, I would double down on this advice. Go to a store like REI that has a fair amount of specialized selection because it will change the quality of your walk. Here’s a life-changing testimonial from a client:

 “I used to avoid walking and had gained a lot of weight because my feet would hurt. It didn’t occur to me that my shoes were a big part of my problem. I thought I’d spend a decent amount on a ‘good brand’ so they must be good. On Shrutee’s recommendation, I went shoe shopping and found out that I needed an E for my shoe toe box. I couldn’t believe how comfortable my feet were when I stepped into them! I now walk a couple miles everyday and actually look forward to walking!! It’s been a game changer. And now I know not to settle for any shoes.”

3. Raised Heels

A shoe that lifts the heel above the forefoot acts like a slide, sending more weight forward onto the ball of your foot. It’s a subtle version of walking in high heels. Over time, this can reduce ankle mobility and create a sense of rushing or skimming when you walk, rather than fully arriving on each step.

Imagine walking on your tiptoes all day. That’s essentially what you’re doing in shoes with raised heels: you’re robbing yourself of grounded contact, and that can affect how your entire skeleton organizes itself.

4. Excessive Cushioning

Shoes with a lot of cushion can feel luxurious at first—like stepping into a soft mattress. But just like overly soft beds, they can leave you sinking rather than supported. When your foot can’t find the ground, your body loses the firm feedback it needs to sense itself in space and maintain healthy bone density.

That feedback loop is part of your proprioceptive system—your body’s internal GPS for sensing where you are in space. Over time, overly cushioned shoes can actually dull your proprioception, making it harder for you to feel stable or grounded in movement.

Shoes Are Only One Part of the Equation

I look for shoes that help me feel grounded and supported, but I don’t treat them like a fix-all. Good footwear is part of the solution. But the other essential piece? A body that knows how to move well and respond to the ground. That’s where having a body movement practice comes in—one that helps you stay supple, agile, and curious about how your body works, not just in exercise but in everyday life and athletic life.

👉 Want to explore this more deeply? Learn about the Sensory Movement Club, a guided space to reconnect with how you move.

FAQs related to this post:

When Should I Replace My Shoes?

heck the soles of your shoes every few months for uneven wear patterns. Disproportionate wear (e.g., along the inner edge for pronation or outer edge for high arches) indicates both shoe bias and body habits that may need adjustment. Replacing worn-out shoes can help rebalance your alignment, and consulting a movement expert may assist in addressing underlying habits.

How Do I Test Shoes in Store?

Here’s an In-Store Shoe Test

1. Stand Test: Stand still in the shoes and notice how your weight is distributed. Are you pitching forward or feeling uneven? 

2. Flexibility Check: Bend the sole gently. It should flex easily with your foot’s natural movement. If it feels stiff, reconsider.

3. Toe Room: Wiggle your toes—can they move freely? They shouldn’t feel squished.

4. Flatness Test: Lay the shoe flat on the ground and inspect to ensure it lays relatively flat without excessive curves or angles.

Do orthotics help with flat feet?

Read here to learn about the pros and cons of orthotics and decide if they are the right choice for you.