Does the evidence base supporting the use of orthotics for the treatment of low back pain (LBP) justify their inclusion within osteopathic practise?

Item

Title
Does the evidence base supporting the use of orthotics for the treatment of low back pain (LBP) justify their inclusion within osteopathic practise?
Author(s)
Ash, G
Abstract
Background: LBP is one of the most common health conditions worldwide and has been reported to affect up to 80% of the population. Various theories connecting foot mechanics to low back pain have been discussed in the literature, providing a possible rationale for the therapeutic value of foot orthotics. These include excessive sub-talar pronation, incorrect shock absorption, sagittal plane blockade theory and functional limb length discrepancy. Within multi...disciplinary practises, it is likely that osteopaths will work alongside podiatrists who have the knowledge, understanding and equipment to prescribe appropriate orthotics. It would therefore be beneficial for osteopaths to have guidelines as to if or when orthotics would be an appropriate addition to treatment. Objectives: Level or reliability will be assessed using the SORT analysis as well as the authors own scoring criteria The following aspects of each study will be analysed: 1. Participants 2. Interventions 3. Outcome measures 4. Length of outcomes 5.Theory used as an explanation of positive outcomes 6. Adverse events/negative implications reported Design: A structured literature review Method: A comprehensive search was carried out in October 2014 within the following online databases: PubMed, Cochrane library, Ebscohost and SwetsWise, The author selected relevant studies, reviewed the outcomes and applied the SORT analysis as well as the authors own criteria to determine the quality of data Results: Thirteen studies were selected, 3 of which used manual therapy as an intervention. Only 1 found a statistically significant reduction in pain levels. Of the 10 studies that did not use manual therapy as an intervention, statistically significant reductions in pain levels were found amongst 7. Discussion: The SORT analysis found the modal value as 2B, whilst the authors own criteria found reduced reliability due to lack of controls, lack of placebos, low participant numbers and studies not mentioning sample size calculations or adverse events. Conclusion: Despite reduction of pain levels seen in most of the studies, the lack of high quality data makes it difficult to endorse orthotic use for the prevention of low back pain alongside osteopathic treatment. It is evident that further, high quality research is necessary within this field.
Date Accepted
2015
Date Submitted
2.12.2016 16:54:55
Type
osteo_thesis
Language
English
Submitted by:
62
Pub-Identifier
15876
Inst-Identifier
1229
Keywords
Low back pain, Orthotics, Osteopathy, Treatment
Recommended
0
Item sets
Thesis

Ash, G, “Does the evidence base supporting the use of orthotics for the treatment of low back pain (LBP) justify their inclusion within osteopathic practise?”, Osteopathic Research Web, accessed April 23, 2025, https://library.wso.at/s/orw/item/605