Clinical Trials Shed Light on Optimal Footwear for Arthritis Pain
Recent clinical research has provided new insights into the best shoes for managing hip and knee osteoarthritis pain, challenging long-held beliefs about footwear stability and support. A study published in the Annals of Internal Medicine reveals that stable, supportive shoes are not always the superior choice, contrary to common advice.
Understanding Osteoarthritis and Its Impact
Osteoarthritis is a degenerative joint condition affecting tissues such as bone, cartilage, ligaments, and muscles, predominantly in older individuals and those with excess body weight. It leads to joint pain, stiffness, and potential disability, with approximately 2.35 million Australians currently diagnosed, a number expected to rise due to aging populations and increasing obesity rates. The hip and knee joints are commonly affected, making walking difficult, and since there is no cure, self-management strategies like appropriate footwear are crucial.
How Footwear Influences Joint Symptoms
Shoes serve as the primary connection to the ground, influencing force transmission up the leg during walking, which can exacerbate osteoarthritis symptoms. High heels, for instance, increase knee forces by an average of 23% compared to barefoot walking. While many assume that supportive features like arch-supporting insoles or stiff soles are beneficial, biomechanical studies indicate these can raise knee forces by up to 15%. Similarly, insoles may increase knee force by 6% when added to shoes.
Key Findings from Clinical Trials
In a 2017 biomechanical study, flat flexible shoes reduced knee forces by 9% compared to stable supportive styles, suggesting potential benefits for osteoarthritis. However, subsequent clinical trials yielded mixed results. A new trial involving 120 people with hip osteoarthritis found no significant difference in pain reduction between flat flexible shoes, such as ballet flats, and stable supportive shoes, like runners, after six months of wear.
In contrast, a 2021 trial with 164 knee osteoarthritis participants showed that stable supportive shoes reduced knee pain by 63% more than flat flexible shoes over the same period. Researchers hypothesize that the disparity may stem from higher joint forces in knee osteoarthritis, allowing supportive shoes to mitigate pain more effectively. Both trials reported more complications, such as foot pain, with flat flexible shoes, likely due to reduced foot protection.
Practical Recommendations for Footwear Selection
For individuals with knee osteoarthritis, stable, supportive shoes are likely more beneficial in alleviating pain. Those with hip osteoarthritis may find neither shoe type superior for pain management. Regardless of condition, older adults, including those with arthritis, should avoid ill-fitting shoes and high or narrow heels to reduce fall risks. Younger individuals without fall concerns should still consider avoiding high heels to minimize joint force increases.
Seeking Professional Guidance
If concerned about hip or knee osteoarthritis, consulting a GP, podiatrist, or physiotherapist is advisable. Additional non-surgical treatments, such as exercise, weight management, nutrition, and pain medications, can complement footwear choices in managing symptoms effectively.
