Today I present you with only the abstract of this article. A systematic review was done of 9 papers encompassing almost 500 patients. The results confirmed what we already know in practice—-That the use of custom made functional foot orthotic devices significantly reduces the patient for 3 subsets of patients. These groups were patients presenting with metatarsalgia, the patients with forefoot pain and rheumatoid arthritis, and the patients presenting with painful bunion deformities. The abstract includes their reference articles for deeper review.
I would love to add that our treatment with orthotic devices can and should be coupled with other treatments when appropriate. Budin splints work well when there is metatarsalgia associated with hammertoes. Metatarsal padding on the orthosis or on the patient’s foot with the goal of metatarsal off loading. Various forms of padding under the forefoot with and without accommodative reliefs. And, of course, the many shoe changes we can play with in terms of varying heel heights, varying amounts of forefoot cushioning, varying amounts of both shoes with rigid soles vs flexible soles, and finally shoes with more or less overall support. Shoes are an area where great patient experimentation can occur.
