Use of Shoe Orthotics Showed Benefit in Reducing Low Back Pain

Use of shoe orthotics for 6 weeks reduced chronic low back pain and
discomfort in patients, according to results of a pilot study published in the
Journal of Manipulative and Physiological Therapeutics.

“The use of shoe orthotics is a common component of treatment in
chiropractic care, with 81.8% of chiropractors prescribing orthotics for 20.9%
of their patients,” said Jerrilyn A. Cambron, LMT, DC, MPH, PhD,
professor in the Department of Research at the National University of Health
Sciences in Lombard, Ill., and principal investigator of this research study.

“Based on our initial study, shoe orthotics appear to reduce low
back pain and discomfort,” she told O&P Business News.

An estimated 84% of the North American population will experience low
back pain at some point in their lives, and one possible cause of this may be
abnormal body biomechanics, according to the researchers. Treatment in
chiropractic care sometimes consists of shoe orthotics in an effort to
influence foot stability and normalize kinetic chain, ultimately improving the
ankle, knee, hip and low back function.

Although some literature supports the use of prescription of customized
shoe orthotics to reduce pain, other research refutes this notion and indicates
that use of insoles does not prevent back pain.

Cambron and her colleagues at the National University of Health Sciences
conducted a randomized clinical trial to investigate the feasibility of shoe
orthotics among 50 participants who were at least 18 years of age or older and
experienced chronic low back pain. Pain was evaluated as symptomatic, with
current pain between the T12 and S1 joints with or without radiating pain, and
the symptoms must have been present for at least 3 months for inclusion in the

Participants were randomized to a treatment group receiving custom-made
shoe orthotics (Ultra Luxury full-length and dress-length models by Foot
Levelers Inc.) or to a waiting-list control group who received the same shoes 6
weeks later. The orthotics were described as “flexible, with three arch
supports situated between a synthetic top and a leather bottom.”

In addition, participants completed biweekly questionnaires during the
12-week study period to assess pain levels, disability, and the use, comfort
and effects of the shoe orthotics.

After measuring changes in perceived pain levels and functional health
status via questionnaire and follow-up clinical visits, the researchers found
that those who used the shoe orthotics for 6 weeks in the early part of the
study had additional positive changes in back pain and disability compared with
the waiting-list group.

Most of the participants in the study were white women in their 50s;
about 40% had leg pain and 50% had foot pain. Baseline back pain levels were
ranked between 5 and 10, according to the study.

“There was a significant pre–post change in the orthotics
group for both the Visual Analog Scale [VAS] and Oswestry Disability Index
[ODI] between the randomization visit and the week 6 visit,” Cambron said.

Participants who were waitlisted to receive shoe orthotics scored a 0.2
reduction on the VAS and 0.2 on the ODI. However, those assigned shoe orthotics
at baseline experienced low back pain reduction of 2.3 on the VAS and 3.37 on
the ODI, according to the study. These participants experienced a
“decrease in overall low back pain levels over the 6 weeks and an overall
decrease in difficulty managing daily life due to pain (e.g., personal care,
lifting, walking, standing, sleeping, etc.),” Cambron said. In addition,
this improvement was maintained through the 12-week study period.

“A larger clinical trial is needed to verify these results because
this was a small pilot study designed to assess feasibility and preliminary
results,” she said. – by Tara Grassia

For more information:

  • Cambron JA, Duarte M, Dexheimer J, Solecki T. Shoe orthotics for
    the treatment of chronic low back pain: a randomized controlled pilot study.
    J Manipulative Physiol Ther. 2011;34(4):254-260.
  • Jerrilyn A. Cambron, LMT, DC, MPH, PhD, can be reached in the
    Department of Research at the National University of Health Sciences, 200 East
    Roosevelt Road, Lombard, IL 60148; e-mail:
  • Disclosure: This study was funded by Foot Levelers, Inc.

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