Abstract
Purpose
Pain in and around the metatarsal heads, the metatarsal phalangeal joints and the surrounding soft tissues is called metatarsalgia. Non-operative treatment of metatarsalgia includes foot orthoses. Foot orthoses may be classified as standard or custom-made. A systematic review was carried out to determine whether custom-made foot orthoses are effective for treating forefoot pain.
Methods
The MEDLINE, CINAHL, The Cochrane Library and PEDro databases were searched for relevant articles reporting patients undergoing treatment for forefoot pain by means of custom-made foot orthoses. Two reviewers independently reviewed all titles and abstracts and extracted the available data. The study eligibility criteria were randomised controlled clinical trials that included participants with forefoot pain treated with custom-made foot orthoses and that reported levels of forefoot pain after the use of orthoses. The data consisted of patient demographics, pathologies related to forefoot pain, type of foot orthoses used, follow-up period and clinical outcomes.
Results
Nine studies were selected which had a total of 487 participants. The pathologies evaluated were rheumatoid arthritis, hallux abductus valgus and isolated and secondary metatarsalgia. The use of custom-made foot orthoses was the intervention that exerted the most significant reduction of the level of pain in the forefoot in most of the studies.
Conclusions
The use of custom-made foot orthoses improved the level of forefoot pain in rheumatoid arthritis, hallux abductus valgus and secondary metatarsalgia as it increases sole pressures.
References
Hawke F, Burns J, Radford J, du Toit V (2008) Custom foot orthoses for the treatment of foot pain: a systematic review. Cochrane Database Syst Rev 3:Art. No.:CD006801. https://doi.org/10.1186/1757-1146-1-S1-O46
Benvenuti F, Ferrucci L, Guralnik JM et al (1995) Foot pain and disability in older persons: an epidemiologic survey. J Am Geriatr Soc 43:479–484
Postema K, Burm PE, Zande ME, Limbeek JV (1998) Primary metatarsalgia: the influence of a custom moulded insole and a rockerbar on plantar pressure. Prosthetics Orthot Int 22:35–44. https://doi.org/10.3109/03093649809164455
Moreno-de-la-Fuente JL (2009) Podología general y biomecánica 2nd edn. Masson/Elservier, Barcelona
Viladot Pericé A 1922-2001 (2001) Patología del antepié. Springer Verlag Ibérica, Barcelona
Kelly A, Winson I (1998) Use of ready-made insoles in the treatment of lesser metatarsalgia: a prospective randomized controlled trial. Foot Ankle Int 19:217–220
Levy Benasuly AE, Cortés Barragán JM (2003) Ortopodología y aparato locomotor :ortopedia de pie y tobillo. Masson, Barcelona
Boismal P, Castells Nat M, Fluvià Creus J et al (2004) Manual de técnicas en ortopodología. Ediciones Especializadas Europeas, Barcelona
Chalmers AC, Busby C, Goyert J et al (2000) Metatarsalgia and rheumatoid arthritis—a randomized, single blind, sequential trial comparing 2 types of foot orthoses and supportive shoes. J Rheumatol 27:1643–1647
Mejjad O, Vittecoq O, Pouplin S et al (2004) Foot orthotics decrease pain but do not improve gait in rheumatoid arthritis patients. Jt Bone Spine 71:542–545. https://doi.org/10.1016/j.jbspin.2003.09.007
Cho NS, Hwang JH, Chang HJ (2009) Randomized controlled trial for clinical effects of varying types of insoles combined with specialized shoes in patients with rheumatoid arthritis of the foot. Clin Rehabil 23:512–521. https://doi.org/10.1177/0269215508101737
Bongi SM, Del Rosso A, Mikhaylova S et al (2014) A comparison of two podiatric protocols for metatarsalgia in patients with rheumatoid arthritis and osteoarthritis. Clin Exp Rheumatol 32:855–863
Tehraninasr A, Saeedi H, Forogh B et al (2008) Effects of insole with toe-separator and night splint on patients with painful hallux valgus: a comparative study. Prosthetics Orthot Int 32:79–83. https://doi.org/10.1080/03093640701669074
Sinha S, Song HR, Kim HJ et al (2013) Medial arch orthosis for paediatric flatfoot. J Orthop Surg (Hong Kong) 21:37–43
Torkki M, Malmivaara A, Seitsalo S et al (2003) Hallux valgus: immediate operation versus 1 year of waiting with or without orthoses: a randomized controlled trial of 209 patients. Acta Orthop Scand 74:209–215. https://doi.org/10.1080/00016470310013987
Higgins JPT, Green S (2011) Manual Cochrane de revisiones sistemáticas de intervenciones. Cochrane 1–639. Available from www.cochrane-handbook.org
Moher D, Liberati A, Tetzlaff J, Altman DG (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 6:e1000097. https://doi.org/10.1371/journal.pmed.1000097
Urrútia G, Bonfill X (2010) Declaraci??n PRISMA: una propuesta para mejorar la publicaci??n de revisiones sistem??ticas y metaan??lisis. Med Clin (Barc) 135:507–511. https://doi.org/10.1016/j.medcli.2010.01.015
Clarke M, Oxman AD (ed) (2003) Manual del Revisor Cochrane 4.1.6. The Cochrane Library, Oxford
The Cochrane Collaboration (2012) Collecting Data / Cochrane Training. http://training.cochrane.org/resource/collecting-data. Accesed 26 Jun 2017
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Ethical approval
This article does not contain any studies with human participants or animals performed by any of the authors.
Appendix 1
Appendix 1
Search strategies applied in the different databases consulted:
MEDLINE con PubMed
-
1.
foot [MeSH Terms]
-
2.
forefoot, human [MeSH Terms]
-
3.
foot bones [MeSH Terms]
-
4.
foot joints [MeSH Terms]
-
5.
sesamoid bones [MeSH Terms]
-
6.
pain [MeSH Terms]
-
7.
pain* [Text Word]
-
8.
OR/1-5
-
9.
OR/6-7
-
10.
8 AND 9
-
11.
foot injuries [MeSH Terms]
-
12.
foot diseases [MeSH Terms]
-
13.
foot deformities [MeSH Terms]
-
14.
arthritis [MeSH Terms]
-
15.
arthrosis [Text Word]
-
16.
tendinopathy [MeSH Terms]
-
17.
fractures, bone [MeSH Terms]
-
18.
neuroma [MeSH Terms]
-
19.
sesamoiditis [Text Word]
-
20.
morton neuroma [Text Word] OR mortons neuroma [Text Word] OR intermetatarsal neuroma [Text Word]
-
21.
OR/14-19
-
22.
8 AND 21
-
23.
OR/11-13, 20
-
24.
OR/10, 22-23
-
25.
orthotic devices [MeSH Terms]
-
26.
insole* [Text Word]
-
27.
in-sole* [Text Word]
-
28.
innersole* [Text Word]
-
29.
in-shoe [Text Word]
-
30.
sole [Text Word] OR soles [Text Word]
-
31.
orthos* [Text Word]
-
32.
orthotic* [Text Word]
-
33.
orthopedic* [Text Word]
-
34.
orthopaedic [Text Word]
-
35.
OR/25-34
-
36.
24 AND 35
-
37.
randomized controlled trial [Publication Type]
-
38.
controlled clinical trial [Publication Type]
-
39.
randomized [Title/Abstract]
-
40.
placebo [Title/Abstract]
-
41.
clinical trials as topic [mh:noexp]
-
42.
randomly [Title/Abstract]
-
43.
trial [Title]
-
44.
OR/37-43
-
45.
animals [MeSH Terms] NOT humans [MeSH Terms]
-
46.
44 NOT 45
-
47.
36 AND 46
CINAHL
-
1.
Foot [MeSH Terms]
-
2.
forefoot
-
3.
Foot Bones [MeSH Terms]
-
4.
foot joint OR foot joints
-
5.
Sesamoid Bones [MeSH Terms]
-
6.
OR/1-5
-
7.
Pain [MeSH Terms]
-
8.
pain*
-
9.
OR/7-8
-
10.
6 AND 9
-
11.
Foot Injuries [MeSH Terms]
-
12.
Foot Diseases [MeSH Terms]
-
13.
Foot Deformities [MeSH Terms]
-
14.
OR/11-13
-
15.
morton neuroma OR mortons neuroma OR intermetatarsal neuroma
-
16.
OR/14-15
-
17.
arthritis [MeSH Terms]
-
18.
arthrosis
-
19.
Tendinopathy [MeSH Terms]
-
20.
Fractures [MeSH Terms]
-
21.
Neuroma [MeSH Terms]
-
22.
sesamoiditis
-
23.
OR/17-22
-
24.
6 AND 23
-
25.
OR/16, 24
-
26.
Orthoses [MeSH Terms]
-
27.
insole*
-
28.
in-sole*
-
29.
innersole*
-
30.
in- shoe
-
31.
sole OR soles
-
32.
orthos*
-
33.
orthotic*
-
34.
orthopedic*
-
35.
orthopaedic
-
36.
OR/26–35
-
37.
25 AND 36
The Cochrane Library
-
1.
MeSH descriptor: [Foot] explode all trees
-
2.
MeSH descriptor: [Forefoot, Human] explode all trees
-
3.
MeSH descriptor: [Foot Bones] explode all trees
-
4.
MeSH descriptor: [Foot Joints] explode all trees
-
5.
MeSH descriptor: [Foot Bones] explode all trees
-
6.
MeSH descriptor: [Pain] explode all trees
-
7.
pain*:ti,ab,kw
-
8.
#1 or #2 or #3 or #4 or #5
-
9.
#6 or #7
-
10.
#8 and #9
-
11.
MeSH descriptor: [Foot Injuries] explode all trees
-
12.
MeSH descriptor: [Foot Diseases] explode all trees
-
13.
MeSH descriptor: [Foot Deformities] explode all trees
-
14.
MeSH descriptor: [Arthritis] explode all trees
-
15.
arthrosis:ti,ab,kw
-
16.
MeSH descriptor: [Tendinopathy] explode all trees
-
17.
MeSH descriptor: [Fractures, Bone] explode all trees
-
18.
MeSH descriptor: [Neuroma] explode all tres
-
19.
sesamoiditis:ti,ab,kw
-
20.
morton neuroma:ti,ab,kw or mortons neuroma:ti,ab,kw or intermetatarsal neuroma:ti,ab,kw
-
21.
#14 or #15 or #16 or #17 or #18 or #19
-
22.
#8 and #21
-
23.
#11 or #12 or #13 or #20
-
24.
#10 or #22 or #23
-
25.
MeSH descriptor: [Orthotic Devices] explode all trees
-
26.
insole*:ti,ab,kw
-
27.
in-sole*:ti,ab,kw
-
28.
innersole*:ti,ab,kw
-
29.
in-shoe:ti,ab,kw
-
30.
sole:ti,ab,kw or soles:ti,ab,kw
-
31.
orthos*:ti,ab,kw
-
32.
orthotic*:ti,ab,kw
-
33.
orthopedic*:ti,ab,kw
-
34.
orthopaedic:ti,ab,kw
-
35.
#25 or #26 or #27 or #28 or #29 or #30 or #31 or #32 or #33 or #34
-
36.
#24 and #35
PEDro
-
Therapy: “orthoses, taping, splinting”
-
Problema: “pain”
-
Body part: “foot and ankle”
-
Method: “clinical trial”
Rights and permissions
About this article
Cite this article
Arias-Martín, I., Reina-Bueno, M. & Munuera-Martínez, P.V. Effectiveness of custom-made foot orthoses for treating forefoot pain: a systematic review. International Orthopaedics (SICOT) 42, 1865–1875 (2018). https://doi.org/10.1007/s00264-018-3817-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00264-018-3817-y