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Insoles for prevention and treatment of back pain

Discussion in 'Biomechanics, Sports and Foot orthoses' started by NewsBot, Jan 18, 2008.

  1. NewsBot

    NewsBot The Admin that posts the news.


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    Insoles for prevention and treatment of back pain.
    Sahar T, Cohen MJ, Ne'eman V, Kandel L, Odebiyi DO, Lev I, Brezis M, Lahad A.
    Cochrane Database Syst Rev. 2007 Oct 17;(4):CD005275
  2. Admin2

    Admin2 Administrator Staff Member

  3. NewsBot

    NewsBot The Admin that posts the news.

    A novel biomechanical device improves gait pattern in patient with chronic nonspecific low back pain.
    Elbaz A, Mirovsky Y, Mor A, Enosh S, Debbi E, Segal G, Barzilay Y, Debi R.
    Spine. 2009 Jul 1;34(15):E507-12.
  4. NewsBot

    NewsBot The Admin that posts the news.

    This clinical trial has just been registered:

    Orthotic Use for Chronic Low Back Pain
    Sponsors and Collaborators: National University of Health Sciences & Foot Levelers, Inc
  5. David Wedemeyer

    David Wedemeyer Well-Known Member

    Great no conflict of interest here, what donkey wazoo. Why even conduct the trial for God's sake?
  6. NewsBot

    NewsBot The Admin that posts the news.

    Orthotic insoles do not prevent physical stress-induced low back pain.
    Mattila VM, Sillanpää P, Salo T, Laine HJ, Mäenpää H, Pihlajamäki H.
    Eur Spine J. 2010 Jul 3. [Epub ahead of print]
  7. Ok so 24 subjects in the tx group had LBP and 42 in the controll group.

    Surely to crunch the stats on those numbers presumes that ascending issues from the feet are the ONLY causes of LBP.

    What if there is a background group of people who will get LBP from an unrelated source (say, sitting posture). That makes a bit of a hash of things because if they were removed from both groups the sets would be nearer and the difference more significant.

    Also, I'm not sure this area is a good one for using infantry recruits because they will have certain characteristics not seen in the bulk of our patient population. Be like saying incontinance pads did'nt work because we tried them on infantry recuits and the no pads set smelled as fresh and confident as the with pads set. Fine, but we're testing a group which is not representative of the target.
  8. Greg Quinn

    Greg Quinn Active Member

    Excellent point Robert. I spent over ten years working in Regional Rehab Centres within the UK for the MoD. The incidence of low back pain secondary to poor initial physical fitness and lack of core stability ran very high for some phase one recruit intakes. Furthermore, pushing on to make an infantry battalion often motivates recruits beyond what most civilian patients would ever encounter (or wish to).
  9. NewsBot

    NewsBot The Admin that posts the news.

    This was finally published:
  10. NewsBot

    NewsBot The Admin that posts the news.

    Shoe orthotics for the treatment of chronic low back pain: a randomized controlled pilot study.
    Cambron JA, Duarte M, Dexheimer J, Solecki T.
    J Manipulative Physiol Ther. 2011 May;34(4):254-60.
  11. Interesting couple of studies (missed the 27 June one)

    Both use a "no treatment" group as their controls. Thus I'm not convinced that such changes that there were cannot be ascribed, at least in part, to placebo. Bit of a shame that.

    I'm always a bit suspicious of research into back pain in infantry recruits because young fit men do not represent the demographic group most of my back pain patients have occupied! One might suggest that fit young people are more likely to suffer back pain through acute injury, rather than chronic positional problems, and that insoles will be unlikely to greatly affect that.

    I'd be very interested in the full text of the Cambron study though! Notwithstanding the lack of placebo group, its always interesting to compare the placebo rate from other trials to the effectiveness rate from insole trials.

    From memory, Sham acupuncture (needles shoved any old where) showed a 40% improvement in pain in Chronic patients.
  12. Brian A. Rothbart

    Brian A. Rothbart Well-Known Member

    First, it is necessary to determine the source of the back pain. If imaging analyses indicate that the back pain is coming from an abnormal foot structure (e.g., Ascending Postural Distortional Pattern) then insoles are indicated.

    Professor Rothbart
  13. dragon_v723

    dragon_v723 Active Member

    Hi Pro Rothbart, when u say insoles are indicated if the pain is from abnormal foot structure, do u know of any recent study confirming/concluding that excessive pronated/supinated gait type can indeed cause the symtpom and what kind of orthotics would you recommend if, for instance, a rigid pes cavus foot type is involed?
  14. :rolleyes:

    I think I know this one...

    Although this is possibly a sign that we need to revisit this.
  15. Brian A. Rothbart

    Brian A. Rothbart Well-Known Member

    To date, there have been no extensive gait studies (that I know of) proving or disproving the link between the feet and low back pain. However, there has been many papers written on the subject (many case studies, some based on subjective outcomes) that do suggest the link between the feet and the low back. You can read one such paper that I published in the late 1980s (Rothbart BA, Esterbrook L, 1988. Excessive Pronation: A Major Biomechanical Determinant in the Development of Chondromalacia and Pelvic Lists. Journal Manipulative Physiologic Therapeutics 11(5): 373-379). (Since then I have published other studies on the subject).

    If you follow Posturology, the rationale for using insoles is very different from the philosophy followed by many Podiatrists in the US and Australia. Namely, Posturologists follow a model I term the Neurophysiological Model. It is very different than the Biomechanical Model first introduced by Root in the mid 1950s. If you are so inclined, in the next issue of Podiatry Review will appear a paper on the subject.

    My area of research and clinical work revolves around the two abnormal inherited foot structures that I have written extensively on (the Rothbarts Foot and the PreClinical Clubfoot Deformity). When I do see a rigid pes cavus foot type, I refer it out.

    with regards,
    Professor Rothbart
  16. Brian

    Has there been any research on your work since we last spoke?

    Any Kinematic or kinetic studies showing the effect of PCI's?

    As you know the balance of opinion (certainly on this board) is that PCI's do not have the effects you claim, either to affect the kinematic changes or to cure the myriad conditions which your website cites. So far the only things you've offered as "evidence" are some before and after photos which to be honest I find quite laughable. I use them in lectures to show how one must examine evidence, not merely take it on faith that what someone claims is true.

    To convince the community, discursive articles or unsupported claims carry little weight. They are, in essence, merely the opinion of somebody with vested interest. Such opinions are ten a penny on the web for anything from insoles curing autism to bleach curing cancer.

    If there is new material you can bring to the table to support your claims then by all means bring it. If not, I cannot see a renewed discussion being any more fruitful than the last.

    Although that said, the first discussion on these insoles, where they were claimed to treat infertility, was one of my first real ground fights on podiatry arena and helped mould what I have become. Perhaps it is time for a new generation of critical thinkers to have this debate and see what they think, approaching it fresh. DCB, Mike, Tim Harmey and a few others have all joined since the "Rothbart era". What do you say boys, you fancy a go?

    By the by, I showed the part of your web-page in which you cite a testimonial for "making a downs syndrome child look normal" to a colleague of mine once (Hi if you're reading M). As a parent of a child with downs syndrome her view was.... negative. Yes, I think negative is a fair assessment. Possibly "strongly negative". Who knows, perhaps she'd like to share her views.

    Is there anything new to show us Brian? Its been a few years, have you done that study yet?
  17. Nope

    Too many bogus claims to even look at it.
  18. You disappoint me weber. ;).

    Isn't it time for a new random song of the week by the way.
  19. Sorry

    And it is I just need to find the version I want - a long long way from Mötorhead

    Have fun boys

    Wonder what Brain's fav möterheads track ?
  20. Got to be "fast and loose".

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