E-Journal

Plantar Fasciitis and Orthoses                                                                                      Issue No. 44

Plantar fasciitis is one of the most common foot complaints. The purpose of this study was to determine the short-term (3 months) and long-term (12 months) effect of three different types of orthoses on patients with plantar fasciitis.

 

Sincerely,
 

Cherri Choate, DPM
Larry Huppin, DPM
Alona Kashanian, DPM
Paul R. Scherer, DPM 

 

Effectiveness of Foot Orthoses to Treat Plantar Fasciitis

 

Methods

  • n = 136 patients with at least a one month history of plantar fasciitis (median = 12 months) 
  • 3 groups: soft foam molded insole (sham), prefabricated firm foam orthosis, custom semirigid polypropylene orthosis
  •  Pain scale and Foot Health Status Questionnaire (FHSQ) at three months and twelve months

 Results

  •  3 month results
    • Pain scale - prefabricated and custom greater improvement than sham
    • FHSQ - prefabricated and custom greater improvement than sham
  • 12 month results
    • Pain scale- all groups improved from 3-month measure, but no difference between sham, prefabricated orthosis and custom orthosis
    • FHSQ- all groups improved from 3 month measure, but no difference between sham, prefabricated orthosis and custom orthosis
Significance of the Article

All three groups experienced improvements in pain and function at 3 and 12 months compared to baseline. Both the prefabricated and customized orthoses produced statistically significant improvements in function compared with the sham orthotics at three months. The authors found that the greatest improvement of pain and function was at the 3-month mark although the improvement was more significant for the function measures than pain.

Significance for Orthotic Therapy

Recently the ACFAS recommended a treatment algorithm for plantar fasciitis which recommended prefabricated orthoses as an initial or Tier 1 treatment option, and prescription orthoses as a Tier 2 treatment option if improvement is unsatisfactory with Tier 1. This study validates the early use of orthosis when treating plantar fasciitis. The prefabricated device in this study was polyethylene foam that resisted flattening with weightbearing. When choosing the first line of orthotic treatment for plantar fasciitis, this study's findings support the principle of a semirigid type of device. Semirigid devices offer the plantar fascia and the longitudinal arch a foundation that discourages plantar fascia tension. Recommending a well-contoured custom device (minimal fill) and a semirigid shell are also substantiated by this study.

References