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Shoe inserts may not help plantar heel pain

Mass-produced shoe inserts available on drugstore shelves and customized orthotics may not work for plantar heel pain, a research review suggests.

Plantar heel pain is one of the most common foot ailments, accounting for about 15 per cent of foot symptoms requiring medical attention and 10 per cent of running injuries, researchers note in the British Journal of Sports Medicine. Many doctors recommend shoe inserts to ease this pain by supporting the arches and taking pressure off the heel, but research to date has been inconclusive about the effectiveness of this approach.

For the current study, researchers examined data from 20 previously conducted experiments that randomly assigned some participants to wear shoe inserts and other participants to join a control group receiving no treatment, a sham insert or a different intervention.

Altogether they tested eight different custom or mass-produced shoe inserts. Short-term pain relief was similar with and without shoe inserts, and there wasn’t any difference between pre-fabricated models and custom versions, the study found.

“A patient might still prefer to try an orthotic and based on this study, could try a cheaper orthotic first as opposed to a more expensive one, which is custom made,” said lead author Nadine Rasenberg of Erasmus Medical Centre Rotterdam in the Netherlands.

‘Based on this study, it appears that the cost of a custom orthotic, which can reach hundreds of dollars, is not medically necessary.’– Dr. Selene Parekh

While shoe inserts might be better than nothing, the current study wasn’t designed to answer this question, Rasenberg said by email.

“Most patients prefer to try an intervention as opposed to a ‘wait and see’ approach,” Rasenberg added. “It remains unknown, whether orthotics are better than doing nothing.”

Orthotics did appear slightly better than sham inserts in the current study, but the difference was too small to rule out the possibility that it was due to chance.

This suggests that orthotics might work for some people, but not others, said Glen Whittaker, a podiatry researcher at La Trobe University in Victoria,

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