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I was just wondering if anyone knows of any research papers showing that custom orthoses are more effective than prefab orthoses in the treatment of plantar fasciitis....

The reason I ask, is that I had a patient the other day who was referred to me for management of plantar fasciitis (aggravated by work). Her insurance company accepted liability for the injury and were happy to pay for the treatment. After I consulted her, I recommended calf stretches, new shoes and custom orthoses.............

Her case manager wrote back to say..."Our insurance company acknowledges your request for custom orthotics.......Can you please confirm why custom made orthotics are recommended over the prefab ones as the study conducted in 1999 stated that there is no difference between the 2 in its effect in pain reduction":bas


The study the case manager was referring to was "Comparison of custom and prefabricated orthoses in the initial treatment of proximal plantar fasciitis.
Pfeffer G, Bacchetti P, Deland J, Lewis A, Anderson R, Davis W, Alvarez R, Brodsky J, Cooper P, Frey C, Herrick R, Myerson M, Sammarco J, Janecki C, Ross S, Bowman M, Smith R.[/b]Resource “Silly Sports and Games”


It is interesting that the insurance company has takin this stand.......But perhaps rightly so?????/

So I have 2 questions:

1. Is there any evidence out there to show that FO are more effective than OTC in the treatment of plantar fasciitis......and
2. Would anyone like to comment on the level of evidence and the qualitity of this research paper that the insurance corecommeded that he have ther so called

Cheers Phantom

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Here is a thread on Karl B. Landorf, PhD; Anne-Maree Keenan, MAppSc; Robert D. Herbert, PhD research on Effectiveness of Foot Orthoses to Treat Plantar Fasciitis from 2006.

Conclusions Foot orthoses produce small short-term benefits in function and may also produce small reductions in pain for people with plantar fasciitis, but they do not have long-term beneficial effects compared with a sham device. The customized and prefabricated orthoses used in this trial have similar effectiveness in the treatment of plantar fasciitis.


And here is another thread titled Prefabricated vs custom made foot orthoses which has the following conclusion:
....At this time, however, it is not possible to recommend either prefabricated or customized orthoses as being better, and it cannot be inferred that customized orthoses are more effective over time and therefore have a cost advantage. Additional good-quality randomized controlled trials are needed to answer these questions.

So to answer your question most research I have read agrees with the insurance company.

Cheers
Brett

Thanks Brett.

Hello people

Its an interesting abstract.

Would anybody happen to have a copy of the article? I can only access the abstract and there are a few things I would like to look at in the paper.

Also, If the soft gell inserts are doing the job, would that mean that impact plays a roll in the occurance of the injury or only on prolonging /agravating the injury?

Cheers
Nick M