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Some shoe insoles don't relieve knee pain
August 20th, 2013
04:01 PM ET

Some shoe insoles don't relieve knee pain

For patients with medial knee osteoarthritis, lateral wedge insoles do not reduce knee pain, according to a new study published in the Journal of the American Medical Association.  Medial knee osteoarthritis is when the cushioning layer (cartilage) between the knees deteriorates over time resulting in the bone rubbing against each other leaving a person with knee pain, stiffness and swelling.  This injury is becoming more prevalent and can make some everyday activities more difficult, including walking, running and using stairs.

Obesity, genetics, biological and environmental factors as well as increased usage can make someone more prone to developing knee osteoarthritis.  Using shoe inserts is a fairly common treatment for knee pain because it's not invasive and it's fairly inexpensive.

Researchers reviewed 12 studies that included a total of 885 participants, 502 who received lateral wedge insoles for the treatment of knee pain.

"We don't seem to see a difference in pain when using a lateral wedge compared to a flat wedge," said lead study author Matthew Parkes. Parkes, who is also a statistician at the University of Manchester, noted that although using the lateral wedge seems like an attractive treatment because it's not invasive - and pretty cheap - the data doesn't support an average overall effect.

Approximately 6% of people in the United States aged 13 and older experience medial knee osteoarthritis, with 12 to 13% of those 6% age 60 and older, says Dr. David Felson, senior study author and professor of medicine at the University of Manchester. He adds 60 to 70% of the 6% have medial disease and would normally be treated by the lateral wedge analyzed in the study.

"It doesn't necessarily mean putting something in your shoes won't work, it just means that these particular ones that are very common and popular are not effective," says Felson. "I personally would discourage patients from using this, but if they said to me I really want to try this, it's easy to use and it's cheap, then I would say go ahead."

"I think that it's a very well-done study," says Dr. Nicholas Fletcher, assistant professor of orthopedic surgery at Emory University, who was not involved in the research. "By putting something in the shoe, it seems patients did better but not statistically better... This study suggests a standard insole should help as much as anything.

Bottom line: "The use of a lateral wedge is not likely to be anymore beneficial than a standard insole would be if you have medial knee osteoarthritis, knee pain," Fletcher says.

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Filed under: Arthritis • Conditions • Orthopedics • Pain

soundoff (45 Responses)
  1. laurie v

    knee pain itself will not go away with insoles. increasing muscle strength – quad, hamstring, glute – will always reduce if not eliminate the pain.

    August 21, 2013 at 23:40 | Report abuse | Reply
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      September 15, 2013 at 12:46 | Report abuse |
    • MyKneeStretches.com

      As a suggestion, stop running until your pain subsides. Then cut your distance by half and run slowly. If the pain returns, see a good podiatrist about your shoes. If you still have pain, see a sports doctor for a checkup. To help get rid of the pain, use RICE!

      January 8, 2014 at 08:59 | Report abuse |
  2. LillyC

    Laurier that simply is not true.. I work with physiotherapists who treat patients with various types of knee pain. Yes Some get better with strength training alone, but many don't. Those who don't are those who require distal control AS WELL AS proximal control. The supination resistance test will tell you who these patients are. If the score is high then there is no way proximal exercises alone are going to reduce the forces acting on the knee. You can pretty much guarantee that those that don't respond to proximal strength training have a high supination resistance score – and therefore they require functional foot orthoses to reduce the supination resistance moment.

    Also, I've treated MANY patients with knee pain that has resolved using orthoses alone. FACT. The key is using the correct type for that patient – it should be a prescription and not a one size fits all scenario.

    August 22, 2013 at 12:14 | Report abuse | Reply
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  5. Knee Pain

    I have personally found that insoles are the best fix to my foot pain. I have been suffering from feet tribulations for the past one year but Insoles really helped with my feet pain.
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    November 29, 2013 at 06:55 | Report abuse | Reply
  6. MyKneeStretches.com

    Hello Trisha Henry,

    Nice article about arthritis. Most likely your knee problem is caused by worn or wrong shoes, running on non-level streets, running on indoor tracks, not stretching correctly or enough, going too fast or too far for your current body-condition. There may be other reasons, but these are the ones that come to mind right now. Good luck!

    January 8, 2014 at 08:56 | Report abuse | Reply
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