Limitations of Orthotics for Heel Pain and Plantar Fasciitis
Plantar heel pain or plantar fasciitis is the most common diagnosis explaining pain originating from the bottom of the foot. Previously, orthotics have been thought to improve alignment of the foot and ankle but more recent research has shown the limitations of these interventions. In our previous blog posts, we have described the inability of orthotics to reduce pain or improve function in a number of conditions including heel pain. In addition, orthotic users show atrophy of the essential core musculature of the foot. A recent review article was published on the available evidence supporting or refuting the use of orthotics for heel pain.
Whittaker and colleagues in the British Journal of Sports Medicine examined 19 studies including 1600 patients with plantar heel pain (2017). The authors found orthotics did not improve pain or function in the short or long term in patients with plantar heel pain. In addition, consistent with prior evidence there was no difference in custom orthotics compared to over the counter orthotics despite a large difference in price.
This study highlights the limitations of orthotics for treatment of plantar heel pain. Patients are encouraged to seek out Physical Therapy treatments, including manual therapy and exercise, for a more effective method of treatment.