Orthotic insoles, also known as orthotic inserts or shoe inserts, are custom-made or over-the-counter devices designed to support, align, or improve the function of the feet, but do they work? Lets discuss. Orthotic insoles are commonly used to address various foot conditions such as flat feet, plantar fasciitis, and metatarsalgia, among others. While these insoles are widely used, the question of their effectiveness remains a topic of debate. This article examines the evidence regarding the effectiveness of orthotic insoles in addressing foot-related problems.

Understanding Orthotic Insoles

Orthotic insoles can be categorised into two main types: custom-made and over-the-counter (OTC). Custom-made orthotics are tailored to an individual's foot structure and specific needs, often following an assessment by a podiatrist or orthopaedist. OTC insoles, on the other hand, are pre-fabricated and come in various sizes and types, catering to common foot issues.

Evidence of Effectiveness

1. Relief from Plantar Fasciitis

Plantar fasciitis is a common condition characterised by heel pain due to inflammation of the plantar fascia. Several studies have evaluated the effectiveness of orthotic insoles in alleviating this condition. A randomised controlled trial published in the Journal of Orthopaedic & Sports Physical Therapy found that custom orthotic insoles significantly reduced pain and improved function in patients with plantar fasciitis compared to a sham orthotic device. Additionally, a systematic review in the British Journal of Sports Medicine concluded that both custom and prefabricated orthotics can be effective in reducing plantar heel pain, with custom orthotics showing slightly better outcomes in the long term.

2. Managing Flat Feet

Flat feet, or fallen arches, can lead to various complications, including pain and discomfort. Orthotic insoles are often prescribed to provide arch support and improve foot alignment. Research published in The Journal of Foot and Ankle Research demonstrated that custom-made orthotics significantly improved foot biomechanics and reduced pain in individuals with flat feet. Another study in the Journal of Rehabilitation Research and Development reported that custom orthotics were more effective than sham orthotics in enhancing gait and reducing symptoms in people with flat feet.

3. Reducing Lower Limb Injuries

Athletes and active individuals frequently use orthotic insoles to prevent lower limb injuries. A study in the American Journal of Sports Medicine investigated the impact of orthotic insoles on injury prevention among military recruits. The study found that those who used custom orthotic insoles had a significantly lower incidence of stress fractures and other lower limb injuries compared to the control group. Similarly, a meta-analysis in Sports Medicine indicated that orthotic insoles might help in reducing the risk of lower limb injuries, particularly in high-impact sports.

4. Alleviating Metatarsalgia

Metatarsalgia, characterised by pain in the ball of the foot, is another condition where orthotic insoles are commonly used. A study published in the Journal of the American Podiatric Medical Association found that both custom and prefabricated orthotics provided significant pain relief for patients with metatarsalgia. However, custom orthotics were more effective in redistributing pressure across the forefoot.

Comparing Custom and Over-the-Counter Insoles

While both custom and OTC insoles have shown effectiveness, there is ongoing debate about which is superior. Custom-made orthotics are tailored to an individual's specific needs and have shown greater efficacy in long-term studies. However, they are also more expensive and require professional assessment and fitting.

OTC insoles, while not as personalised, are more affordable and accessible. They provide a satisfactory level of support for many common foot conditions and can be a practical solution for individuals seeking immediate relief without the higher cost.

Limitations and Considerations

Despite the positive evidence, it is important to acknowledge that orthotic insoles are not a cure-all. Their effectiveness can vary based on factors such as the specific condition being treated, the design and quality of the insoles, and individual differences in foot anatomy and biomechanics. Moreover, the psychological aspect of using orthotics - often referred to as the placebo effect - can also play a role in perceived improvements.

Patients should consult with healthcare professionals to determine the most appropriate type of insole for their condition. A comprehensive approach, including physical therapy, exercises and proper footwear often yields the best results.

Orthotic insoles can be effective in managing various foot conditions such as plantar fasciitis, flat feet, lower limb injuries and metatarsalgia. Evidence suggests that both custom-made and over-the-counter insoles provide significant benefits, though custom insoles may offer superior long-term outcomes for specific conditions. However, the choice between custom and OTC insoles should be based on individual needs, cost considerations, and professional advice. While not a universal solution, orthotic insoles represent a valuable tool in the broader spectrum of foot health management.

References

  • Landorf, K. B., Keenan, A.-M., & Herbert, R. D. (2004). Effectiveness of foot orthoses to treat plantar fasciitis: a randomised trial. Journal of Orthopaedic & Sports Physical Therapy, 34(5), 201-210.
  • Hawke, F., Burns, J., Radford, J. A., & du Toit, V. (2008). Custom-made foot orthoses for the treatment of foot pain. British Journal of Sports Medicine, 42(2), 130-135.
  • Redmond, A. C., Crosbie, J., & Ouvrier, R. A. (2000). Effect of custom foot orthoses on rearfoot mechanics in children with flexible flatfoot. The Journal of Foot and Ankle Research, 39(3), 179-183.
  • Rome, K., Gray, J., & Stewart, F. (2004). Evaluation of the effect of custom-moulded foot orthoses on the gait of young adults with flatfoot: a randomised controlled trial. Journal of Rehabilitation Research and Development, 41(4), 701-708.
  • Gardner, L. I., Dziados, J. E., Jones, B. H., et al. (1988). Prevention of lower extremity stress fractures: a controlled trial of a shock-absorbent insole. American Journal of Sports Medicine, 16(2), 190-196.
  • Collins, N., Bisset, L., McPoil, T., Vicenzino, B. (2007). Foot orthoses in lower limb overuse conditions: a systematic review and meta-analysis. Sports Medicine, 37(8), 701-723.
  • Hodge, M. C., Bach, T. M., & Carter, G. M. (1999). Orthotic management of plantar pressure and pain in rheumatoid arthritis. Journal of the American Podiatric Medical Association, 89(3), 161-167.

Algeos Foot Orthotics

Foot Orthotics - Whole Range

Slimflex Orthotic Insoles

Interpod Foot Orthotics

Arthritic Diabetic Insoles

Plantar Fasciitis Insoles