This article is a transcribed edited summary of a video Bob and Brad recorded in February of 2022. For the original video go to https://youtu.be/qu2rsvLYNvw
Bob: Today, we’re going to talk about arch supports, Brad. I’m seeing a lot of commercials on tv lately.
Brad: Sure.
Bob: They claim, “If you come into our shop, we’ll fit you with an arch support and it will take away your back pain.” I didn’t know if that was true or not. I mean, what do the studies say? So, I did some research. We are going through this one study. It’s actually a study of studies.
Brad: Oh, a meta-analysis.
Bob: Yes.
Brad: How many studies did they group together?
Bob: I don’t remember. It’s called “Foot Orthotics for Low Back Pain: The State of Our Understanding and Recommendations for Future Research.” It was by Papuga and Cambron. Brad and I always like meta-analysis because basically, it’s a study of studies. They look through PubMed and EBSCO, Gale, Google Scholar, and clinical trials.
Brad: Right, so it’s a broad search of a number of studies and just see how they compare and contrast.
Bob: So, unfortunately, Brad, what they found is that none of these were high-quality studies. None of them.
Brad: Wow!
Bob: So, they cannot recommend using an arch support. On the positive side, they said there were some studies that were in trial right now.
Brad: I have heard people say they put arch supports in and their back pain got better. So, either they are making it up or it’s just an individual thing.
Bob: You know, you have the placebo effect where that comes into place.
Brad: Right.
Bob: I think if you’re going to try an arch support, what I would recommend is that you don’t pay for one as far as a custom made one goes.
Brad: Yes, they are very expensive.
Bob: We did find studies that showed that customer made ones were not really any better than ones that you get off the shelf.
Brad: Right, and there will be controversy on that.
Bob: I know there will be.
Brad: Especially by the people who make them.
Bob: Exactly. Do you want to show what an arch support does? Why it might help back
pain?
Brad: So, these are 2 inserts. You pull out of your shoe and this one is a flat insert. It’s not made to do any arch support. If my foot was inside a shoe with an arch support, it’s flat, there’s no support on my arch with this flat one. There’s an air gap in there. So, this is just a little cushion on your heel and your forefoot.
Brad: This is not a true arch support insert though but it will give you an idea to use to demonstrate. You can see how the insert comes up and supports the arch. Now, if you have a true arch support insert, there’s going to be a cushion right in the arch and you’ll feel it. When you walk, you are going to feel that support on the arch.
Bob: If you don’t have good arch support, what can happen is the foot collapses in and that could cause the knee to collapse in, which is going to affect the pelvis, which is going to affect the back.
Brad: That’s the idea.
Bob: It makes sense that it possibly could help and plus, I think an arch support gives you a little bit of cushioning when you walk.
Brad: I think they do usually have cushion along with it.
Bob: Certainly, they do recommend that a lot. If you work on a hard surface like cement, you can go ahead and put a cushion in your shoe.
Brad: Right, so that it takes that impact, and all your joints can be helped that way. I have to admit, I used to put a cushioned arch support in all my running shoes. An over the counter one, but they weren’t the cheap $5 ones. They were a little bit better. Then I changed my whole running style where now I don’t use them at all. I don’t know if we want to get into that.
Bob: No, we don’t. We do want to talk about Stuart McGill, who did recommend that walking, simple walking, can help your back pain. It doesn’t need an arch support for that. He wants you to walk three times a day, if you can, after every meal and for up to 15-20 minutes, but most of you couldn't do that to start. Maybe you’re going to start with one time a day. You might even start by marching in place and doing some stairs.
Brad: Right. He even advocates, making sure you tighten up your abs, get your core in line so your back feels good and make sure you’re cognizant of that posture while you walk. It’s not just walking without thinking. You have to get your back in tune.
Bob: Do not increase your pain. Do it in chunks where it’s not painful. The other thing is you might try walking at a higher speed and at a higher rate. Unfortunately, what they found is that it actually takes some weight off your spine when you walk a little faster. I saw this happen in a lot of patients of mine. The other thing is you want to have good posture. What you might want to do is grab your arms, grab your wrist behind you and pull back. If you’re bent over leaning forward, it’s going to pull you up and put you in a good posture and then you walk forward or, as you’re walking just check out where you’re at. Again, work up to it and you’ll find out that the back has a lot of joints, and this helps kind of lubricate it. It’s kind of like the tinman.
Brad: Get some motion in there. We’ve got some natural lubrication. Synovial fluid and every facet joint, each vertebra has two of those.
Bob: You get the blood flowing and you’re going to find out your back pain is going to do better if you can walk. It was one of the first things we have patients do. Make sure you are on a walking program.
Brad: Right, not up and down hills though, on the flat surface.
Bob: So, arch support, maybe you want to try it. Don’t spend a lot of money. It should feel good on the foot.
Brad: Right, it should feel good. It should make your back feel good, obviously.
Bob: Don’t let people tell you that you have to adjust to it. You know, when you put it in your shoe. It should feel good right away.
Brad: Yeah, I’ve had salespeople do that in the shoe store, then I leave. Or get another one.
Bob: Alright, thanks!
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