Custom insoles versus sham and GP-led usual care in patients with plantar heel pain: results of the STAP-study – a randomised controlled trial

Review written by Ian Griffiths info

Key Points

  1. Plantar heel pain (PHP) is the most common overuse issue affecting the foot, and the benefits of using foot orthoses for its management is a source of much debate.
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BACKGROUND & OBJECTIVE

Plantar heel pain (PHP), commonly referred to as plantar fasciitis by many, is an incredibly common complaint within both general (1) and athletic (2) populations. It is accepted as being the most common overuse issue affecting the foot (3). The use of foot orthoses in the management of this condition generates much debate, with the two most recent systematic reviews (4,5) drawing opposing conclusions from almost the exact same data!

The objective of this double blinded RCT (with pragmatic design within a primary care setting) was to compare custom-made foot orthoses to GP-led “usual care” within a cohort of PHP sufferers. The authors hypothesized that custom-made foot orthoses would be superior at 12 weeks with respect to the primary outcome measure (differences in pain at rest and during activity on an 11-point Numerical Rating Scale).

Plantar heel pain is the most common overuse issue affecting the foot.
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Based on the findings of this study, clinicians should have reservations in prescribing custom-made foot orthoses for plantar heel pain.

METHODS

A total of 185 participants were recruited (age range: 18-65) who all reported pain at the medial rearfoot for at least 2 weeks duration. Key exclusion criteria were: symptom duration for greater than 2 years, previous orthoses use, trauma, and

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