Priority 12 from the Foot Health PSP

UNCERTAINTY: Do foot orthoses (including insoles/gel devices/ankle supports) reduce foot pain and problems? (JLA PSP Priority 12)
Overall ranking	12
JLA question ID	0092/12
Explanatory note	The use of foot orthoses in the management of general painful foot problems in both adults and children is common place within healthcare and the general public has easy access to the purchase of a range of devices across a range of retail high street and online providers. However, the evidence base to support the use of foot orthoses is limited and/ or weak for many common foot pathologies. Research is needed to demonstrate what the most effective foot orthoses are, the mechanisms by which they are effective, for how long and for which foot and ankle pathologies they are most effective, in order to provide a strong evidence base for the use of the most clinically effective orthotic interventions for a diverse range of foot pathology.
Evidence	CD006311 – Rome et al (2010). Non-surgical interventions for paediatric pes planus. There is very limited evidence for the use of foot orthose/footwear interventions in the management of paediatric pes planus. CD001256 – Yeung et al (2011). Interventions for the reduction of lower limb soft tissue running injuries. Overall weak evidence – custom made orthoses may be more effective than no insole for reducing risk of Medial Tibial Stress Syndrome. Protocols for Cochrane reviews of interventions: CD 012304.Rogers JA et al (2016) Physical Interventions (orthoses, splints, exercise and manual therapy) for treating plantar heel pain.
Health Research Classification System category	Generic health relevance

Extra information provided by this PSP
Original uncertainty examples	What is the evidence for the use of foot orthoses in management of foot health problems? ~ Is Orthotics a long-term solution to my foot health problems? ~ How effective are orthotics in treating OA in the feet.
Submitted by	Healthcare professional x 7, Patient x 5

PSP information
PSP unique ID	0092
PSP name	Foot Health
Total number of uncertainties identified by this PSP.	30 (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website)
Date of priority setting workshop	26 September 2019