Plantar fasciopathy, a condition involves inflammation of tissues plantar fascia that extends from the heel to toes is one of the primary reason to have heel pain. The management includes the use of foot orthoses, especially custom-made foot orthoses in new shoes may reduce pain more effectively, and this study concentrates on finding the effectiveness of these custom footwear. 

Foot orthoses used frequently to manage plantar fasciopathy in clinical practice. Despite the fact, very limited evidence present that shows the effect of both actually custom designed foot orthoses, as well as the shoe in which the foot orthoses are set. This study examined the impact of using custom foot orthoses and new athletic footwear on average 24-h pain, plantar fascia thickness and first-step pain in people with unilateral plantar fasiopathy past 12 weeks. 

A parallel, double-blind, three-arm randomised controlled trial was conducted which involved 60 patients identified with unilateral plantar fasciopathy. These patients were randomly categorised into either a sham insole fixed in the participant’s regular shoes (control group) or custom foot orthoses and new shoes (orthoses group), a sham insole with a new shoe (shoe group). The first-step pain was considered as the primary outcome and plantar fascia thickness measured on ultrasound & average 24-h pain as secondary outcomes. These outcomes were evaluated at baseline, four week and 12-week trial time-points.

The orthoses group showed less first-step pain compared to the control group at fourth week (p = 0.002), and on the 12th week, the orthoses group exhibited less first-step pain compared to both the sham (p = 0.01) and the shoe (p = < 0.001) groups. At 4 and 12 weeks, both the shoe (p = 0.006) and orthoses (p = < 0.001) groups described less average 24-h pain compared to the control group. Also, the orthoses group illustrated decreased plantar fascia thickness on ultrasound as compared to both control (p = 0.011) and shoe (p = 0.032) groups.  

Custom foot orthoses in new shoes reduce first-step pain and minimise plantar fascia thickness across a period of 12 weeks as compared to new shoes individually or a sham intervention.