A case-series study to explore the efficacy of foot orthoses in treating first metatarsophalangeal joint pain

• Main Authors: Welsh Brian J, Redmond Anthony C, Chockalingam Nachiappan, Keenan Anne-Maree
• Format: Article
• Language: English
• Published: BMC 2010-08-01
• Series: Journal of Foot and Ankle Research
• Online Access: http://www.jfootankleres.com/content/3/1/17

<p>Abstract</p> <p>Background</p> <p>First metatarsophalangeal (MTP) joint pain is a common foot complaint which is often considered to be a consequence of altered mechanics. Foot orthoses are often prescribed to reduce 1^stMTP joint pain with the aim of altering dorsiflexion at propulsion. This study explores changes in 1^stMTP joint pain and kinematics following the use of foot orthoses.</p> <p>Methods</p> <p>The effect of modified, pre-fabricated foot orthoses (X-line^®) were evaluated in thirty-two patients with 1^stMTP joint pain of mechanical origin. The primary outcome was pain measured at baseline and 24 weeks using the pain subscale of the foot function index (FFI). In a small sub-group of patients (n = 9), the relationship between pain and kinematic variables was explored with and without their orthoses, using an electromagnetic motion tracking (EMT) system.</p> <p>Results</p> <p>A significant reduction in pain was observed between baseline (median = 48 mm) and the 24 week endpoint (median = 14.50 mm, z = -4.88, p < 0.001). In the sub-group analysis, we found no relationship between pain reduction and 1^stMTP joint motion, and no significant differences were found between the 1^stMTP joint maximum dorsiflexion or ankle/subtalar complex maximum eversion, with and without the orthoses.</p> <p>Conclusions</p> <p>This observational study demonstrated a significant decrease in 1^stMTP joint pain associated with the use of foot orthoses. Change in pain was not shown to be associated with 1^stMTP joint dorsiflexion nor with altered ankle/subtalar complex eversion. Further research into the effect of foot orthoses on foot function is indicated.</p>