Back pain is one of the most common health problems in the industrialized world, with estimates that between 60% and 85% of the population will experience it at some point in their lives. Laboratory trials suggest that the use of shoe insoles might be beneficial in the prevention and treatment of back pain, by absorbing the shock of the foot striking the ground and supporting the foot in proper alignment. There are a variety of insoles available.
We included six trials that studied populations who did extensive standing and walking in the course of their daily jobs. Three prevention studies (2061 participants) examined the effects of both customized and non-customized insoles for the prevention of back pain. Three studies with mixed populations (256 participants) examined the effects of customized insoles for back pain without being clear whether they were aimed at primary or secondary prevention or treatment. None of the studies showed that insoles prevented back pain. No included trials assessed insoles exclusively for treatment for back pain.
Although half of the trials were of high methodological quality and therefore had a low potential for bias, the results should still be read with caution. Most of the trials examined specific young, highly active male populations. Finally, no long-term treatment and prevention data are available.
In conclusion, there is strong evidence that insoles do not prevent back pain, while the current evidence on insoles as treatment for low-back pain does not allow any conclusions. Better trials assessing the association between insoles and back pain are required before professional recommendation for the use of insoles become standard.