Back pain and the prevention of back pain is a major focus of research time, money, and energy right now. The fact that over 100 billion dollars is spent each year in direct and indirect costs associated with back pain tell us how big a problem this is.
There have been many efforts to see what kind of treatment works best for back pain. Likewise, there has been an equal focus on finding ways to prevent back pain from developing. One of those interventions has been the use of shoe insoles.
A systematic review of the literature regarding the use of insoles for the prevention and treatment of back pain was carried out and reported on. The authors used a well-known method of study review: the Cochrane Handbook. The Cochrane Collaboration is a group of over 15,000 volunteers in more than 90 countries. The group reviews the effects of health care interventions (treatment) tested in biomedical randomized controlled trials. The results of these systematic reviews are published as Cochrane Reviews in the Cochrane Library. Health care professionals rely on Cochrane Reviews as valid and accurate summaries on many topic of interest.
The results of this systematic review may have found a lack of evidence to support the use of insoles as a treatment for low back pain but that’s not the end of the discussion. That lack of evidence was related to poor research design in some of the studies already done. Without clear criteria for the selection of patients included in studies, proper analysis of data, and the collection of complete data, the evidence can be presented as favorable when, in fact, the evidence is really limited. That was the case in studies reviewed using insoles for the treatment (vs. prevention) of low back pain.
Where does that leave us on the issue of shoe insoles for the prevention or treatment of low back pain? That’s a good question. Right now, there are so many different kinds of insoles on the market, it’s difficult to know if perhaps a specific insole might be the answer. Some are customized, others are not.
Most of the large studies were done on military (male) soldiers. We don’t really have much information on women or older adults regarding this issue. And some of the studies reported a shift of pain from the back to the legs.
The authors concluded that there is strong evidence that insoles don’t prevent back pain. More trials are needed to come to any conclusions about the use of insoles to treat back pain. And, the book is wide open on whether or not there’s one single insole that’s the best or if certain insoles work better for some problems than others.