Katherine Margo, MD
Are custom-made foot orthoses effective for different types of foot pain?
Studies selected compared custom-made foot orthoses (in-shoe devices that were molded or milled from an impression of the foot and fabricated according to practitioner-prescribed specifications) with no treatment, standard treatment received by both groups, or another intervention for foot pain of any type in patients of any age. Primary outcome was foot pain.
MEDLINE, EMBASE/Excerpta Medica, CINAHL, Cochrane Central Register of Controlled Trials, and Physiotherapy Evidence Database (to Jun 2007); and reference lists were searched for randomized controlled trials (RCTs) or controlled clinical trials. Experts were consulted. 11 RCTs (n = 1332) met the selection criteria. 3 RCTs reported adequate concealment of allocation, and 5 RCTs reported blinding of patients and/or outcome assessors.
The Table shows the results. Baseline pain scores ranged from 32 to 65 (median 54) on a scale of 0 to 100 (worst).
Custom foot orthoses are effective for foot pain associated with rheumatoid arthritis (rear foot pain), juvenile idiopathic arthritis, and pes cavus. Evidence on effectiveness for foot pain of hallux valgus or plantar fasciitis, or metatarsophalangeal joint pain in rheumatoid arthritis, is insufficient.
Individual randomized controlled trials of custom-made foot orthoses (CFOs) to reduce foot pain
*On a scale of 0 to 100 (worst). Negative differences favor CFOs. CI defined in Glossary.
†Statistically significant difference.
Margo K. Review: Custom-made foot orthoses are effective for some types of foot pain. Ann Intern Med. ;149:JC6–12. doi: 10.7326/0003-4819-149-12-200812160-02012
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Published: Ann Intern Med. 2008;149(12):JC6-12.
Rheumatoid Arthritis, Rheumatology.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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