Customized orthotics failed to alter the long-term course of plantar fasciitis.
Although foot orthotics frequently are prescribed for plantar fasciitis, their long-term effect on pain and function has not been evaluated. In a participant-blinded study, researchers randomized 136 patients with plantar fasciitis symptoms for at least 4 weeks to receive one of three orthotics: sham, prefabricated, or customized. Patients with histories of major orthopedic or medical conditions that could have affected the fasciitis were excluded. Participants were not allowed to receive nonsteroidal anti-inflammatory drugs or steroid injections, although 23% of patients ultimately broke the protocol.
All patients noted improvement in pain and function at 3- and 12-month follow-up. At 3 months, patients randomized to prefabricated or customized orthotics, compared with those randomized to sham orthotics, had significantly improved function (by approximately 8 points on a scale of 100) but no significant improvement in pain. At 12 months, no significant differences between groups were found in pain or in function.
These researchers found limited, short-term improvement in function, but not in pain, among patients who received either prefabricated or customized orthotics. At 12 months, neither the customized nor the prefabricated orthotics proved to be superior to a sham orthotic. The findings suggest that orthotics alone fail to alter the long-term course of plantar fasciitis; the study did not evaluate the effect of orthotics in conjunction with anti-inflammatory agents or exercise.
Reference:
Landorf KB et al. Effectiveness of foot orthoses to treat plantar fasciitis: A randomized trial. Arch Intern Med 2006 Jun 26; 166:1305-10.