Foot orthoses for plantar heel pain: a systematic review and meta-analysis.

OBJECTIVE

To investigate the effectiveness of foot orthoses for pain and function in adults with plantar heel pain.

DESIGN

Systematic review and meta-analysis. The primary outcome was pain or function categorised by duration of follow-up as short (0 to 6 weeks), medium (7 to 12 weeks) or longer term (13 to 52 weeks).

DATA SOURCES

Medline, CINAHL, SPORTDiscus, Embase and the Cochrane Library from inception to June 2017.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

Studies must have used a randomised parallel-group design and evaluated foot orthoses for plantar heel pain. At least one outcome measure for pain or function must have been reported.

RESULTS

A total of 19 trials (1660 participants) were included. In the , there was very low-quality evidence that foot orthoses do not reduce pain or improve function. In the , there was moderate-quality evidence that foot orthoses were more effective than sham foot orthoses at reducing pain (standardised mean difference -0.27 (-0.48 to -0.06)). There was no improvement in function in the medium term. In the , there was very low-quality evidence that foot orthoses do not reduce pain or improve function. A comparison of customised and prefabricated foot orthoses showed no difference at any time point.

CONCLUSION

There is moderate-quality evidence that foot orthoses are effective at reducing pain in the medium term, however it is uncertain whether this is a clinically important change.