The Center for Podiatric Care and Sports Medicine

Do Custom Orthotic Devices Work To Help Foot Pain?

Posted by on Monday, January 20th, 2014

The global orthotics market is predicted to reach $4.7 billion by 2015, according to Global Industry Analysts. Orthotic devices include molded shoe inserts purchased over-the-counter from a drug store or custom-molded inserts cast in a podiatrist’s office and manufactured off-site.

Orthoses have been recommended to treat everything from knee pain and plantar fasciitis to spinal pain and nerve pain. They are said to help people with highly arched feet, as well as people with flat feet — both supinators and pronators. Yet, there have been mixed reviews about the value of custom-made shoe inserts over the years.

foot orthoses
People seeking relief from foot pain may suffer pronation and supination. Image Source: GFerreira.co.za

Opinion: Orthoses Do Work

There are too many studies on the effectiveness of orthotic devices to list them all here, but we’ll mention a few:

– A 1988 study published in the Journal of Orthopedic Sports Physical Therapy reported that a whopping 96% of 53 people with chronic foot pain found relief with custom orthoses.

– A 2006 study published in the journal Foot Ankle International found a 30 to 50% reduction in pain among night splint and foot orthoses users with plantar fasciitis at 12 weeks. By 52 weeks, the two groups using orthoses had a 62% reduction in pain, compared to 48% for the patients using night splints only. A year later, 19 of 23 patients were still using their foot orthoses, compared to just one patient who complied with a doctor’s recommendation to use the night splint.

– The Cochrane Systematic Review done in 2008 examined 1,332 people in 11 trials and found that custom foot orthoses relieved pain within three months for adults with rheumatoid arthritis and children with juvenile arthritis. Adults with highly arched feet or prominent big toe joints reported foot pain relief within six months.

shoe inserts
Although many people report that they experience some relief by using orthoses, the jury is still out on their effectiveness. Image Source: LowerExtremityReview.com

Opinion: Benefits Of Orthoses Are Limited

One journalist told the story of how a general dull ache turned into debilitating pain when he began a daily dog-walking regimen. He admittedly went to a new orthotic shop, without doing much research. He concluded that “the orthotic support for around the house did provide modest relief in my slippers/flip flops. But the pain did not go away.” Steve Caplan, writing for the UK Guardianadded that he finally delved deeper into the world of orthotic engineering research after 10 adjustments failed to provide him with adequate relief.  “I found that the jury was definitely still out on their efficacy, at least from a scientific standpoint,” he concluded.

The problems were that:

A) There are many manufacturers with no understanding of biomechanics releasing shoddy products on the market,

B) There is little understanding how orthoses help decrease foot pain,

C) The foot impressions taken would be different during a walk, versus a run, and D) Many studies seemed inaccurate — omitting the people who dropped out of the trial in their analysis, for example.

Some professionals say, at this point, it’s more about “trial and error” than actual science.

chronic foot pain treatment
Some say the orthotic market is more about trial and error than science. Image Source: Infogr.am

Orthotic Devices: A Sports Medicine Professional’s Opinion

Our very own Dr. Nadia Levy, a podiatrist at The Center for Podiatric Care and Sports Medicine in New York, strongly believes that orthoses work for many different foot issues. “Do they work for all foot problems?  No.  Do they work all the time?  No,” she says. “In some cases, the problem may be too far gone to help with orthoses. But they are helpful to a lot of people experiencing chronic pain and they are certainly worth a try in order to avoid a more aggressive condition that requires much more invasive treatments.”

If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.