Can orthotic shoe insoles be used to treat knee, hip and or low back pain?

Can orthotic shoe insoles be used to treat knee, hip and or low back pain?

The short answer is ‘Yes.’

The longer answer is ‘Yes, but I wouldn’t see them as a good long-term solution.

Here’s why:

Many years ago, I did a 2 day course on Orthotic insole prescription. I completed the course having come to the following conclusions:

1) In some instances, orthotic insole can be useful to reduce knee, hip or low-back pain. Pain relief in these circumstances is achieved by supporting load transfer through the foot which affect rotational forces going up the leg. Reducing these forces can reduce the loading up the kinetic chain and therefore reduce pain at the knee, hip or low back.

2) In most instances of low back, hip or knee pain a simple ‘Off the Shelf’ orthotic for £20-30 would be sufficient. There seems no need for expensive prescription orthotics in these circumstances. IE There was no need for the type of orthotics I had just been trained to prescribe for the majority of the patient types I saw. (NB I discovered last week that my thoughts many years ago are now backed up by clinical trial evidence.)

So, Yes…. orthotic insoles can quickly and cheaply be used for the reduction of knee, hip and low back pain in some circumstances. The pain relief is achieved by adding external support to your body, a crutch! Therefore, in my opinion it makes sense to limit the use of orthotic insoles to periods of time when acute painful symptoms are flared up and then, once things have calmed down try and help the body develop it’s own strength and ability to cope rather than risk creating a dependence.

An opposite viewpoint may be that ‘Off the Shelf’ orthotic insoles are acceptable as a long-term solution, because they can be effective at minimal effort from the patient which I will concede is a relevant argument in some circumstances.

I cannot, however, see any rationale to support the prescription of personalised orthotics at around £400 per pair for either short or long-term knee, hip or low back pain.

In summary: ‘Off the Shelf’ orthotic insoles can help some instances of biomechanical lower limb and low back pain. A trained eye can easily assess the three main foot types (Normal, Flat Foot and High Arch) and assess how well the foot is functioning. This could be done quickly via either a video call or a single appointment and doesn’t require a complex and expensive fitting process.

If you want to discuss this further please don’t hesitate to get in touch.

Adam Richmond
Osteopath – Specialising in the treatment of chronic low back and hip pain.

Registered Osteopath, GOsC 7813

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