Foot News

Plantar Pressure with and without Custom Insoles in Patients with Common Foot Complaints
March 21, 2012

Scientific News in Foot Pain (Part 4):

Plantar Pressure with and without Custom Insoles in Patients with Common for Complaints
Treatment of common foot problems often includes the use of foot insoles or orthotics (these terms mean essentially the same thing). These items are often not covered by many insurance plans. The prices for these insoles can vary from $20-$400. Therefore, it is important to determine for which problems they are effective. It is also important to determine which problems require the more expensive types of insoles and which can be treated by the more economical types of insole.

Dr. Stolwijk and his associates (Stolwijk NM et al. Plantar pressure with and without custom insoles in patients with common foot complaints. Foot Ankle Int. 2011 Jan;32(1):57-65.) evaluated foot pressures after his patients had been fitted for insoles for many common for complaints. He did this using a special machine that evaluates the way that pressure is spread across the foot. Many similar machines are used in pharmacies and shoe stores. While the information that is obtained from these machines may be helpful, it is only one part of foot examination. It is questionable whether this information alone is useful in treating foot problems.

They found that the pressure under the foot decreases significantly under the heel and the ball of the foot (lesser metatarsal heads). They found that the changes did not very much between inserts or for different diagnoses.

Many studies have found few improvements in satisfaction between custom and non-custom inserts. In clinical practice, there are a few situations in which a custom insert may be designed to perform certain very specific functions in the treatment of foot conditions. However, for the majority of problems, a non-custom, much more economical orthotic can be expected to work as well as a custom orthotic.

      –Brett Fink, MD.  Co-author of The Whole Foot Book:  A Comprehensive Guide to Taking Care of your Feet