Effectiveness of custom-made foot orthoses for treating forefoot pain

NewsBot · Feb 10, 2018

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Effectiveness of custom-made foot orthoses for treating forefoot pain: a systematic review.
Arias-Martín I et al
Int Orthop. 2018 Feb 8. doi: 10.1007/s00264-018-3817-y.

PURPOSE:
Pain in and around the metatarsal heads, the metatarsal phalangeal joints and the surrounding soft tissues is called metatarsalgia. Non-operative treatment of metatarsalgia includes foot orthoses. Foot orthoses may be classified as standard or custom-made. A systematic review was carried out to determine whether custom-made foot orthoses are effective for treating forefoot pain.

METHODS:
The MEDLINE, CINAHL, The Cochrane Library and PEDro databases were searched for relevant articles reporting patients undergoing treatment for forefoot pain by means of custom-made foot orthoses. Two reviewers independently reviewed all titles and abstracts and extracted the available data. The study eligibility criteria were randomised controlled clinical trials that included participants with forefoot pain treated with custom-made foot orthoses and that reported levels of forefoot pain after the use of orthoses. The data consisted of patient demographics, pathologies related to forefoot pain, type of foot orthoses used, follow-up period and clinical outcomes.

RESULTS:
Nine studies were selected which had a total of 487 participants. The pathologies evaluated were rheumatoid arthritis, hallux abductus valgus and isolated and secondary metatarsalgia. The use of custom-made foot orthoses was the intervention that exerted the most significant reduction of the level of pain in the forefoot in most of the studies.

CONCLUSIONS:
The use of custom-made foot orthoses improved the level of forefoot pain in rheumatoid arthritis, hallux abductus valgus and secondary metatarsalgia as it increases sole pressures.
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NewsBot · Mar 21, 2018

The effect of different foot orthoses on pain and health related quality of life in painful flexible flat foot: a randomized controlled trial.
Yurt Y et al
Eur J Phys Rehabil Med. 2018 Mar 16. doi: 10.23736/S1973-9087.18.05108-0.

BACKGROUND:
Foot orthoses are widely used in conservative treatment of painful flexible flatfoot however research is limited to choose the best option in orthotic treatment.

AIM:
We aimed to compare the effects of computer-aided design/computer-aided manufacturing (CAD-CAM) and conventional insole types in comparison with sham insole, on pain and health related quality of life in patients with painful flexible flatfoot.

DESIGN:
Randomized controlled trial.

SETTING:
Outpatient rehabilitation clinic.

POPULATION:
Sixty-seven people with painful flexible flatfoot, aged between 18 and 45 years, were assigned to CAD-CAM (n=22), conventional (n=22) or sham (n=23) groups.

METHODS:
In addition to insoles, a home-based exercise program was followed by all participants for eight weeks. Foot pain intensity and quality of life were assessed at the initial evaluation and at the end of two-month follow-up.

RESULTS:
Pain intensity (Mean±SD, mm on VAS) was significantly lower in CAD-CAM (27.84±18.41) and conventional (27.05±16.82) insole groups than sham group (46.39±20.18) after two months (p<.05), but there was no difference between conventional and CAD-CAM (p>.05). All groups had significantly higher physical health scores at the second assessment (p<.05), but there was no intergroup difference (p>.05).

CONCLUSIONS:
CAD-CAM and conventionally designed insoles are both more effective than having sham insole in alleviating pain in painful flexible flatfoot.

CLINICAL REHABILITATION IMPACT:
CAD-CAM and conventionally designed semicustom insoles in conjunction with a home-based exercise program are both effective in controlling pain compared with sham insole and exercise in painful flexible flatfoot. Clinicians can prescribe both types of semicustom insoles as a part of conservative treatment instead of each other.
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terigreen · Aug 7, 2018

NewsBot said: ↑

Effectiveness of custom-made foot orthoses for treating forefoot pain: a systematic review.
Arias-Martín I et al
Int Orthop. 2018 Feb 8. doi: 10.1007/s00264-018-3817-y.
Click to expand...

Interesting article, thanks for posting. One thing that I did not read is the use of prefabricated orthotics and heat moldable orthotics. We the high cost of health care in the USA and insurance companies pay less and less, an inexpensive prefabricated or heat mold orthotic can make a huge difference. In my experience, a well-made heat moldable orthotic will do as much as a custom one. Plantar Fasciitis can become an expensive diagnosis for our patients, lets start at a low price point for them.

Thanks,

Teri Green
Atlas Biomechanics

NewsBot · Dec 11, 2023

Enhancing Functional Rehabilitation Through Orthotic Interventions for Foot and Ankle Conditions: A Narrative Review
Momin Mohaddis et al
Cureus. 2023 Nov 20;15(11):e49103.

Non-surgical, conservative approaches to foot and ankle conditions are of important consideration. Orthotics play a significant role in treating these conditions, preventing progression, and alleviating pressure on affected areas, thereby promoting normal gait. This article aims to assess the utility and effectiveness of various orthotic treatments in different clinical scenarios. We reviewed 27 peer-reviewed articles using electronic databases, employing keywords such as "orthoses," "orthotic treatment," "arthritis," "neuropathy," and "foot and ankle trauma." Studies conducted in recent decades have explored the effectiveness of orthoses in various conditions, including connective tissue disorders, tendon and ligament injuries, foot arthritis, neuropathic and inflammatory wounds, and sports-related recurrent injuries. Orthotic management has proven effective across diverse foot and ankle conditions. Integrating orthotic treatment with systemic approaches benefits patients with foot and ankle disorders. We believe this review can be utilised by clinicians in the management of foot and ankle disorders.
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