Foot orthotics for low back pain: The state of our understanding and recommendations for future research

• A review of the biomechanical mechanisms underlying the effectiveness of foot orthotic treatment.
• A review of the current state of knowledge regarding the clinical use of foot orthotics to treat and/or prevent the occurrence of low back pain.
• A discussion of the most influential studies in the area of foot orthotic conducted during the past decade.
• Recommendations based on our review that may prove useful in directing future clinical research are provided.

PurposeThe purpose of the article is to evaluate the literature on the use of foot orthotics for low back pain and to make specific recommendations for future research.MethodsDatabase searches were conducted using PubMed, EBSCO, GALE, Google Scholar, and clinicaltrials.gov. The biomedical literature was reviewed to determine the current state of knowledge on the benefits of foot orthotics for low back pain related to biomechanical mechanisms and clinical outcomes.ResultsIt may be argued that foot orthotics are experimental, investigational, or unproven for low back pain due to lack of sufficient evidence for their clinical effectiveness. This conclusion is based upon lack of high quality randomized controlled trials (RCTs). However, there is extensive research on biomechanical mechanisms underlying the benefits of orthotics that may be used to address this gap. Additionally, promising pilot studies are beginning to emerge in the literature and ongoing large-scale RCTs are addressing effects of foot orthotics on chronic low back pain.ConclusionsBased upon the critical evaluation of the current research on foot orthotics related to biomechanical mechanisms and clinical outcomes, recommendations for future research to address the evidence-practice gaps on the use of foot orthotics for low back pain are presented.