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Efficacy of foot orthoses for the treatment of plantar heel pain: a systematic review and meta-analysis
  1. Nadine Rasenberg1,
  2. Henrik Riel2,
  3. Michael S Rathleff2,
  4. Sita M A Bierma-Zeinstra1,
  5. Marienke van Middelkoop1
  1. 1 Department of General Practice, Erasmus Medical Center, Universitair Medisch Centrum, Rotterdam, The Netherland
  2. 2 Research Unit for General Practice in Aalborg, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
  1. Correspondence to Dr Nadine Rasenberg, Department of General Practice, Erasmus Medical Center, Universitair Medisch Centrum, Rotterdam 2040, CA, The Netherland; n.rasenberg{at}


Background Plantar heel pain (PHP) is common. Foot orthoses are often applied as treatment for PHP, even though there is little evidence to support this.

Objective To investigate the effects of different orthoses on pain, function and self-reported recovery in patients with PHP and compare them with other conservative interventions.

Design Systematic review and meta-analysis.

Data sources A systematic literature search was conducted in MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Web of Science, CINAHL and Google Scholar up to January 2017.

Eligibility criteria for selecting studies Randomised controlled trials comparing foot orthoses with a control (defined as no intervention, sham or other type of conservative treatment) reporting on pain, function or self-reported recovery in patients with PHP.

Results Twenty studies investigating eight different types of foot orthoses were included in the review. Most studies were of high quality. Pooled data from six studies showed no difference between prefabricated orthoses and sham orthoses for pain at short term (mean difference (MD) of 0.26 (95% CI −0.09 to 0.60)). No difference was found between sham orthoses and custom orthoses for pain at short term (MD 0.22 (95% CI −0.05 to 0.50)), nor was there a difference between prefabricated orthoses and custom orthoses for pain at short term (MD 0.03 (95% CI −0.15 to 0.22)). For the majority of other interventions, no significant differences were found.

Conclusions Foot orthoses are not superior for improving pain and function compared with sham or other conservative treatment in patients with PHP.

PROSPERO registration number CRD42015029659.

  • orthotics
  • foot
  • foot injuries

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  • Contributors All five authors made a substantial contribution to the design the drafting and the revising of the manuscript and have read and approved the final version. None of the authors has a direct or indirect commercial financial incentive associated with publishing this article. All five authors agree to be accountable for all aspects of the work to ensure that questions related to the accuracy or integrity of the work are appropriately resolved.

  • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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