Plantar fascia pain is the most common foot complaint we see as physiotherapists. The pain associated with plantar fasciitis is typically around the heel but can be in other parts of the sole of the foot. The pain is often worse in the morning and for the first few steps after being seated for some time.
Plantar foot pain can vary from mild to very debilitating and often our patients report that the symptoms have been present for quite some time. The most common question we get asked by patients with plantar fasciitis is “do I need to see a podiatrist for orthotics”?
Our answer, probably not because research has shown no difference in effectiveness between the prescription of prefabricated orthoses (like the ones we use here at Out of the Box Physio) vs custom made orthotics.
The first study to look at this was Pfeffer et.al (1999) in their journal article. Further to this, in 2008 a review was published in the Cochrane database with the following conclusions for plantar fasciitis “Custom foot orthoses may not reduce foot pain after 2-3 months or 1 year compared to non-custom foot orthoses.
So the current evidence suggests expensive custom-made orthotics are generally no more effective than cheaper non-customised ones.
To make sure we make the right prescription here at Out of the Box Physiotherapy we will tape your foot to simulate what an orthotic might do before prescribing them. This allows us to measure the response that the arch support and correction might provide and allows us to make a clinical decision based on your response (i.e. did it reduce pain and help you symptoms). We call this a treatment direction test and we use this to then develop a treatment plan, based on footwear advice, exercises to load and strengthen the foot and possibly some arch support in the form of orthotics if we think this would be necessary.
Be aware of the big claims made on the TV about arch support and how they are “good” for your feet and make physio your first point of call for heel pain or plantar fasciitis. We have heard of patients spending upwards of $1500 on arch supports at a retail shop that really are no more effective than a $60 pair we would fit here at Out of the Box Physio. You might not only save a reasonable amount of money, but you will actually get a solution that works towards long term relief rather than a temporary fix.
If you have any questions about your foot pain please get in touch. We are more than happy to give you some advice.
1. Pfeffer G, Bacchetti P, Deland J, et al. Comparison of Custom and Prefabricated Orthoses in the Initial Treatment of Proximal Plantar Fasciitis. Foot & Ankle International. 1999;20(4):214-221. doi:10.1177/107110079902000402
2.Hawke F, Burns J, et al. Custom-made foot orthoses for the treatment of foot pain. Cochrane Database Syst Rev. 2008;16:CD006801.