Insoles for prevention and treatment of back pain: a systematic review within the framework of the Cochrane Collaboration Back Review Group.
METHODS
A systematic review of randomized controlled trials.


OBJECTIVE
To determine the effectiveness of shoe insoles in the prevention and treatment of nonspecific back pain compared with placebo, no intervention, or other interventions.


BACKGROUND
There is lack of theoretical and clinical knowledge of the use of insoles for prevention or treatment of back pain.


METHODS
We searched electronic databases from inception to October 2008. We reviewed reference lists in review articles, guidelines, and in the included trials; conducted citation tracking; and contacted individuals with expertise in this domain. One review author conducted the searches and blinded the retrieved references for authors, institution, and journal. Two review authors independently selected the relevant articles. Two different review authors independently assessed the methodological quality and clinical relevance and extracted the data from each trial using the criteria recommended by the Cochrane Back Review Group.


RESULTS
Six randomized controlled trials met inclusion criteria: 3 examined prevention of back pain (2061 participants) and 3 examined mixed populations (256 participants) without being clear whether they were aimed at primary or secondary prevention or treatment. No treatment trials were found. There is strong evidence that the use of insoles does not prevent back pain. There is limited evidence that insoles alleviate back pain or adversely shift the pain to the lower extremities.


CONCLUSIONS
There is strong evidence that insoles are not effective for the prevention of back pain. The current evidence on insoles as treatment for low back pain does not allow any conclusions.
Family Medicine Department, Hebrew University, Jerusalem, Israel. talisahar@gmail.com
Tali
T
Sahar
Matan J
MJ
Cohen
Vered
V
Uval-Ne'eman
Leonid
L
Kandel
Daniel Oluwafemi
DO
Odebiyi
Ishay
I
Lev
Mayer
M
Brezis
Amnon
A
Lahad
D001416:Back Pain / Q000517:prevention & control* / Q000628:therapy*; D006801:Humans; D015201:Meta-Analysis as Topic; D016032:Randomized Controlled Trials as Topic; D012775:Shoes