Using insoles may not reduce back pain

There is strong evidence that using insoles does not prevent people from getting non-specific back pain, and there is insufficient evidence to say whether or not they help solve existing low-back pain, a Cochrane Systematic Review has found.

Back pain is one of the most common health problems in the industrialised world. It comes second only to upper respiratory infection as a reason for people to visit a doctor in the USA. Up to 85% of people in the USA suffer from back pain at one point in their lives.

Some people have suggested that insoles in shoes might help by absorbing shock, keeping the foot more stable as it touches the ground and helping the person's walking action to become more stable and fluent.

A team of Cochrane Researchers searched the international literature for relevant studies and found six randomised controlled trials that met their inclusion criteria. These involved over 2300 participants. The researchers came to two main conclusions:

1. there is strong evidence that the use of insoles does not prevent back pain in someone who does not have it already, and,
2. there is limited evidence that using insoles may reduce back pain in people who have pain – but it may also shift the pain from the back to the legs.

“We do need some good studies of the effect of insoles on existing or recurrent back pain, so that we can make recommendations with a greater sense of certainty,” says lead researcher Dr Tali Sahar who works at the Department of Family Practice at the Hebrew University, Jerusalem, Israel.