For over 20 years now, one of my main educational pillars has been teaching how the feet and its three arches are critical in the support of the entire body.
I have become proficient over the years explaining how the arches are important not only to the feet, but the entire axial kinematic chain of stress that moves up to the ankles, knees, hips, pelvis, spine, upper extremity and the skull. In teaching this information to other chiropractors, students, and my patients, I have to rely on my passion, communication skills, and my own successful case studies (which are numerous) to help convey my recommendations.
In an effort to really offer value and the need for arch support, I have used various statements to give my words as much weight as possible. “I have done this for so many years in practice and it works so well for the patients.” “The company I use is one of the oldest in chiropractic and they make the orthotics by hand for each patient.” “I wear these orthotics and so do with my wife, my kids, and my staff.” “The orthotics will help you hold your adjustments longer and help your spine and body stabilize.” Although these statements are true in my experience, they are not beyond scientific reproach.
The truth is there are many chiropractors and other healthcare providers who understand that the arches of the feet do have an important role to play in whole-body stability. Many believe in using custom orthotics, but there are so many choices out there, it can be confusing. Some use rigid, semi-rigid, off-the-shelf. Lots of choices and confusion abound. There are still others who don’t believe that orthotics help people feel better. I have heard the remark that “there’s no research to support orthotics can help people.”
Well, now exciting new research has been published to give us “arch supporters” real firepower behind our explanations of how effective custom molded, three arch orthotics can be for lower back pain. While preliminary studies have established the effectiveness of foot orthotics in treating a number of conditions, including low back pain, the most recent findings are irrefutable. That is why this new study is so helpful and monumental in its findings.
The study is called “Shoe Orthotics for the Treatment of Chronic Low Back Pain: A Randomized Controlled Trial,” published in September 2017 by the Archives of Physical Medicine and Rehabilitation. It was a follow-up study for a pilot study, also performed at National University of Health researched, and published in The Journal of Manipulative and Physiological Therapeutics in 2011. The results of that study were significant enough to warrant further study.
This new study offers most conclusive evidence yet that foot orthotics, specifically flexible custom orthotics with three arch correction, help patients with chronic lower back pain and dysfunction. The study found…
- 3 percent improvement of function with flexible custom orthotics and chiropractic care.
- For the group that only had the flexible orthotics (no chiropractic), improvement in function was still 18.9%
- Lower back pain improved 34.5 percent for those wearing flexible custom orthotics (with no chiropractic).
- The most staggering finding was the 40.4 percent improvement of lower back pain with the flexible custom orthotics and the chiropractic adjustments.
The study was financed by Foot Levelers, Inc. and they provided the custom orthotics for the study exclusively.
The journal that published the study is the well-respected Archives of Physical Medicine and Rehabilitation, established in 1945. It is the publication of the American Congress of Rehabilitation Medicine. By publishing this study, it places chiropractic care, a chiropractic clinical product, and chiropractic research in front of medical providers in a specialty that has a patient base similar to that of chiropractic. The journal has very strict publication guidelines. Studies with low quality design, methodology, relevance, and writing are not accepted. In 2008, the journal was ranked 9th among the top 27 physical medicine and rehabilitation journals and 12th among the top 72 sports science journals.
From both a teaching and business perspective, it is exciting to a have a very compelling tool that supports the usage of flexible custom orthotics. I am enthusiastic about the findings because it gives me more validity with Chiropractors and medical professionals that I teach.
How can you implement this study in your practice? Let me give you a few ideas:
- During your report of findings you have explained the role the feet play in the overall support of the body. Having a picture of the front page of the study along with the summary of the findings will help your patient understand how effective orthotics can be.
- Have copies of the study available for patients in the reception area or consultation room of your office. Some of you may find the whole study to be too much information, so just offer the front page and summary of the results (like explained in bullet #1)
- Educate your staff on the findings of the study so they can reinforce this with your patients when they are ordering or checking out of the office. Remember, your staff is a powerful point of contact with every patient. Some patients will trust their words and advice in support of or in addition to yours. The study is easy to understand and easy for your staff to get excited about and relay this to patients.
- Use the study when you reach out to local health care providers you work with or would like to establish relationships with. So many health professionals are unconvinced by case studies or testimonials—they need to see it validated in trusted source. This study, published in a trusted medical journal, really hammers home how well the orthotics and chiropractic work.
- Use the study to help teach your patients about the differences between all of the different orthotics out on the market. Many of the orthotics sold by healthcare providers or in stores have only one arch of the foot. Most orthotics are rigid or semi-rigid plastic, making them both less comfortable and shock-absorbant. The ones used in the study were flexible, three arch correcting, and custom-made for each participant.
- Use the bullet points from the study to present at your spinal workshops; spinal screenings; sporting events or any of the other events where you have contact with the general public. People love to hear proof that things work! You have the ability to get people excited and give them hope.
I hope you have been able to see how much of an advantage we now have in prescribing and supporting the need for custom flexible orthotics in your practice. Patient education is where we shine and this new article is a very powerful tool you can use. When the foot hits the ground, everything changes. Now we have proof!