Shoe Orthotics for the Treatment of Chronic Low Back Pain: A Randomized Controlled Trial

Publication date: Available online 30 April 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Jerrilyn A. Cambron, Jennifer M. Dexheimer, Manuel Duarte, Sally Freels
ObjectivesTo investigate the efficacy of shoe orthotics with and without chiropractic treatment for chronic low back pain as compared to no treatment.DesignRandomized Controlled TrialSettingAn integrative medicine teaching clinic at a Midwestern university.ParticipantsTwo hundred and twenty-five adult subjects with symptomatic low back pain of 3 months or longer were recruited from a volunteer sample.InterventionsSubjects were randomized into one of three treatment groups (Orthotics, Plus, and Wait-list Groups). The Orthotics Group received custom-made shoe orthotics The Plus Group received custom-made orthotics plus chiropractic manipulation, hot or cold packs, and manual soft tissue massage. The Wait-list Group received no care.Main Outcome MeasuresThe primary outcome measures were change in perceived back pain (Numeric Pain Rating Scale) and functional health status (Oswestry) after 6 weeks of study participation. Outcomes were also assessed after 12 weeks and then after an additional 3, 6, and 12 months.ResultsAfter six weeks, all three groups demonstrated significant within-group improvement in average back pain, but only the Orthotics and Plus Groups had significant within-group improvement in function. When compared to the Wait-list Group, the Orthotics Group demonstrated significantly greater improvements in pain (p<0.0001) and function (p=0.0068). The addition of chiropractic to orthotics treatment demonstrated significantly greater improvements in function (p=0.0278) when compared to orthotics alone, but no significant difference in pain (p=0.3431). Group differences at 12 weeks and later were not significant.ConclusionsSix weeks of prescription shoe orthotics significantly improved back pain and dysfunction compared to no treatment. The addition of chiropractic care led to higher improvements in function.



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