Medical Education

Below are peer reviewed articles from medical journals which, using evidence based research and testing, prove that custom orthotics truly work and can change your life. The reviews provided by Arcus Orthotics are unbiased, reliable and prove custom foot orthotics efficacy.

Pain Relief

A 2004 study of 275 patients with custom foot orthoses for over a year, the majority of patients felt between 60-100% relief of symptoms with only 9% reporting no symptoms of relief.

Walter JH, Ng G, Stoitz JJ: A patient satisfaction survey on prescription custom-molded foot orthoses. JAPMA, 94:363-367, 2004

Plantar Fasciitis

75% reduction in disability rating and a 66% reduction in pain rating with foot orthoses occurred.

Gross MT, Byers JM, Krafft JL, Lackey EJ, Melton KM: The impact of custom semirigid foot orthotics on pain and disability for individuals with plantar fasciitis. J Ortho Sp Phys Ther, 32:149-157, 2002.

This 2004 article review stated that the evidence suggests that foot orthoses produce reductions in pain and disability associated with plantar fasciitis.

Karl B. Landorf, Anne-Maree Keenan, and Robert D. Herbert Effectiveness of Different Types of Foot Orthoses for the Treatment of Plantar Fasciitis J Am Podiatr Med Assoc 2004 94: 542-549

This study demonstrated that when custom functional orthoses were given to patients with plantar fasciitis a 75% reduction in disability rating and a 66% reduction in pain rating occurred. This is a straight forward and conclusive study concerning quantification of effectiveness.

Gross, MT, Byers, JM, Krafft, JL, Lackey, EJ, Melton, KM. The impact of custom semi rigid orthoses on pain and disability for individuals with plantar fasciitis. Journal of Orthopaedic and Sports Physical Therapy 2002;32:149-157.

This prospective clinical outcome study during eleven months that compared custom orthotic therapy with and without steroidal or non-steroidal therapy on 84 patients with 133 painful heels. The study demonstrated that 89% of patients receiving only the orthotic therapy had total or more than 80% relief of their symptoms. 7% received partial relief and 4% no relief. Maximum relief was achieved at an average of 5.4 weeks.

Scherer, PR, et al. Heel spur syndrome, pathomechanics and non-surgical treatment. Journal of the American Podiatric Medical Association 1991; 81:68-72


Orthotics can be used to reduce pressure on the ball of the foot in order to relieve pain in this area. The following articles review orthotic therapy for ball-of-foot pain and in particular evaluate the exact placement of pads in order to achieve the best possible clinical outcome. Aligning anatomical structure from spiral X-ray computed tomography with plantar pressure data.

Hastings MK, Commean PK, Smith KE, Pilgram TK, Mueller MJ. Clin Biomech (Bristol, Avon). 2003 Nov;18(9):877-82.

Optimum position of metatarsal pad in metatarsalgia for pressure relief.

Hsi WL, Kang JH, Lee XX. Department of Rehabilitation, National Taiwan University Hospital, Taipei, Republic of China. Am J Phys Med Rehabil. 2005 Jul;84(7):514-20.


In a 2000 study, research on patients with rheumatoid arthritis (RA) showed a significant improvement in pain and a decrease in foot disability when the patients wore custom foot orthoses.

Chalmers AC, Busby C, Goyert J, Porter B, Schulzer M: Metatarsalgia and rheumatoid arthritis-a randomized, single blind, sequential trial comparing two types of foot orthoses and supportive shoes. J Rheum, 27:1643-1647, 2000.

In a 2005 study published in the Journal of Rheumatology, a randomized trial of 40 children with juvenile idiopathic arthritis were found to have significantly greater improvements in overall pain, speed of ambulation, foot pain and level of disability when they wore custom foot orthoses when compared to those in the study that received shoe inserts or shoes alone.

Powell M, Seid M, Szer IA: Efficacy of custom foot orthotics in improving pain and functional status in children with juvenile idiopathic arthritis: A randomized trial. J Rheum, 32:943-950, 2005.

In a study that measured pain relief in 64 subjects with osteoarthritis in the foot and ankle, 100% of the patients wearing orthoses had significantly longer relief of pain than those patients receiving only non-steroidal anti-inflammatory drugs.

Thompson JA, Jennings MB, Hodge W: Orthotic therapy in the management of osteoarthritis. JAPMA, 82:136-139, 1992.

In a 2000 study, both normal and rheumatoid arthirtis subjects showed significant reductions in plantar pressures and loading forces during the stance phase of gait with foot orthoses.

Li CY, Imaishi K, Shiba N, Tagawa Y, Maeda T, Matsuo S, Goto T, Yamanaka K: Biomechanical evaluation of foot pressure and loading force during gait in rheumotod arthritic patients with and without foot orthoses. Kurume Med J, 47:211-217, 2000.

Chronic lateral ankle instability

This research suggests that custom-fit orthotics may restrict undesirable motion at the foot and ankle and enhance joint mechanoreceptors to detect perturbations and provide structural support for detecting and controlling postural sway in ankle-injured subjects.

Guskiewicz KM, PerrinDH: Effects of orthotics on postural sway following inversion ankle sprain. J Orthop Sp Phys Ther, 23:326-331, 1996

Knee pain

In a 2003 study of 102 athletic patients with patellofemoral pain syndrome, 76.5% of patients improved and 2% were asymptomatic after 2-4 weeks of receiving the custom foot orthoses.

Saxena A, Haddad J: The effect of foot orthoses on patellofemoral pain syndrome. 93:264-271, 2003.

A study of 30 persons with medial knee osteoarthritis were given foot orthoses with a 5 degree lateral wedge. At 6 weeks, all subjects had some relief and 28 found the orthoses comfortable.

Russel Rubin and Hylton B. Menz. Use of Laterally Wedged Custom Foot Orthoses to Reduce Pain Associated with Medial Knee Osteoarthritis: A Preliminary Investigation. J Am Podiatr Med Assoc 2005 95: 347-352.

Back pain

In this 1999 study, subjects experienced more than twice the improvement in alleviation of pain, and for twice as long, compared with subjects in a study using traditional back-pain treatment.

Dananberg HJ, Guiliano M: Chronic low-back pain and its response to custom-made foot orthoses. 89:109-117, 1999

Flat feet

One of the worst kinds of flat foot is due to the weakening or rupture of a tendon called the posterior tibialis. The condition is known by several names including posterior tibialis dysfunction, posterior tibial tendon dysfunction and tibialis posterior dysfunction. The weakening of this tendon leads to an “Adult Acquired Flatfoot” – a progressive flattening of one or both feet. The following articles are related to orthotic treatment of posterior tibialis dysfunction.

Kirby KA: Conservative treatment of posterior tibial dysfunction. Podiatry Management, 19:73-82, 2000.

High arch

Patients with a high-arched foot frequently experience foot pain, which can lead to significant limitation in function. Custom orthoses are widely used to treat these problems.

Burns J, Crosble J. Effective Orthotic Therapy for the Painful Cavus Foot. J Am Pod Med Assoc. 96:3: 205 – 211. 2006


Comfort ratings were significantly different between orthotic conditions electromyography (EMG) that partially explained differences in comfort of the cases correctly to the corresponding orthotic condition.

Mundermann A, Nigg BM, Humble RN, Stefanyshyn DJ: Orthotic comfort is related to kinematics, kinetics, and EMG in recreational runners. Med Sci Sports Exercise, 35:1710-1719, 2003b

An improvement in symptoms did occur with the 6-week intervention. In addition, dynamic results revealed that custom foot orthoses (CFO) have an immediate effect on dynamics and that this influence occurs only when orthoses are worn in the footwear. The short-term CFO intervention led to significant decreases in rearfoot kinematics (maximum eversion angle and velocity).

MacLean CL, Hamill J: Short and long-term influence of a custom foot orthotic intervention on lower extremity dynamics in injured runners. Annual ISB Meeting, Cleveland, September 2005.

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