Osteoarthritis (OA) can affect various parts of the body. One is the feet, and the most common area of the foot that’s affected is what doctors call the first metatarsophalangeal joint (MTPJ). To the rest of us, it’s the joint in the big toe. OA in the big toe can cause an inability to move the toe, which not only affects the way a person walks but also can result in stiffness and considerable pain.
In the past, modified footwear and specially designed orthoses, which are shoe inserts that are contoured to the user’s foot, have been used to treat OA in the MTPJ. However, no controlled study has been conducted to determine how well they work. Recently, researchers in Australia completed just such a study.
The researchers recruited 102 patients with OA in the joint of the big toe and randomly assigned them to use either individualized prefabricated foot orthoses or rocker-sole footwear (shoes with a thick sole that’s rounded at either one end or both). After using these devices for 12 weeks, the participants rated their foot pain using the Foot Health Status Questionnaire (FHSQ). The researchers found that the FHSQ pain scores improved in both groups, with no statistically significant difference between them.
But even though pain relief was about the same in both groups, there was a difference of another kind. The footwear group showed what the researchers called “lower adherence” — that is, they did not use their device as often or for as long as the orthoses group did. In addition, the people who wore the rocker soles more frequently reported “adverse events” — blisters, discomfort, impaired balance, falling, and pain in the back, hip, or knee.
The researchers pointed out that their study was limited in that it did not follow the patients for a long period of time, but otherwise, they concluded that although rocker soles and orthoses are both effective in reducing pain in the big toe, “prefabricated foot orthoses may be the intervention of choice due to greater adherence and fewer associated adverse events.”