Low back pain is one of the most common health problems in the US. It is often caused by regular stresses on the low back such as high-impact activities, long periods of standing, poor posture, poor lifting techniques, and weak muscles. Foot orthoses like shoe inserts have become a convenient and common tool to combat back pain because they are believed to reduce impact and improve alignment of lower body and spine.
Researchers from Australia wanted to determine if shoe insoles or foot orthoses were actually effective in the prevention and treatment of low back pain. The study, published in BMC Journal of Musculoskeletal Disorders, found that there is not enough evidence to support the use of insoles or orthoses.
The systematic review included 11 studies: 5 randomized trials looked at treatment and 6 randomized trials looked at prevention of low back pain with shoe insoles or foot orthoses. Only published reports of randomized controlled trials or crossover trials that compared orthoses or insoles with no treatment or placebo were included in the review.
After the review, the study concluded that there is not enough evidence to support the use of shoe insoles or foot orthoses as either a treatment for low back pain or in the prevention of low back pain.
A systematic review is considered a reliable form of research because it combines several smaller studies. The higher the number of participants the more reliable the results may be. However, the systematic review is only as reliable as the studies that were included. In this case, all of the included trials had some quality issue which may affect the reliability of outcomes. This review does match other study outcomes that failed to find a benefit of shoe insoles for back pain.
Low back pain can be caused by a variety of problems which may explain why some have pain relief with shoe inserts but studies have failed to find benefits in large groups. Work with your doctor to help manage back pain. Staying active, yoga, acupuncture, and massage have been shown to be helpful for some to manage back pain. Experiment with different techniques to find what works best for you and avoid activities or habits that may make your back worse such as long periods of sitting or standing, smoking, poor posture, and sedentary behavior.
American Academy of Orthopaedic Surgeons
National Institute of Neurological Disorders and Stroke
Low back pain. American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=a00311. Updated December 2013. Accessed June 9, 2014.
Low back pain fact sheet. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/disorders/backpain/detail_backpain.htm#260483102. Published April 16, 2014. Accessed June 9, 2014.
Chuter V, Spink M, et al. The effectiveness of shoe insoles for the prevention and treatment of low back pain: a systematic review and meta-analysis of randomised controlled trials. BMC Musculoskelet Disord. 2014 Apr 29;15(1):140.
Last reviewed June 2014 by Michael Woods, MD