Reducing pain in patients with osteoarthritis of the big toe

Prefabricated foot orthoses and rocker-sole footwear (in which the sole of the shoe is curved) are effective at reducing peak pressure under the big toe in people with a condition called first metatarsophalangeal joint osteoarthritis, but new research shows that they achieve this through different mechanisms. Also, rocker-sole shoes exhibited lower peak pressure under the lesser toes and midfoot, while orthoses increased peak pressure in these areas.

Investigators found that both were similarly effective for relieving big toe joint pain in patients; however, prefabricated foot orthoses may be the intervention of choice because patients were more likely to use them, and they were less likely to cause back pain, discomfort, or impaired balance.

"Osteoarthritis affecting the big toe joint is a common and disabling condition," said Prof. Hylton Menz, lead author of the Arthritis Care & Research studies, which were funded by the National Health and Medical Research Council of Australia, "Our research suggests that footwear and orthoses may help alleviate pain by altering the distribution of load under the foot when walking."