Clinical Studies
Comparison of Custom and Prefabricated Orthoses in the Initial Treatment of
Proximal Plantar Fasciitis
Glenn Pfeffer, M.D., Peter Bacchetti, Ph.D., Johnathan Deland, M.D., Al Lewis, M.D., Robert Anderson, M.D., William Davis, M.D., Richard Alvarez, M.D., James Brodsky, M.D., Paul Cooper, M.D., Carol Frey, M.D., Richard Herrick, M.D., Mark Myerson, M.D., James Sammarco, M.D., Chet Janecki, M.D., Steven Ross, M.D., Michael Bowman, M.D., and Ronald Smith, M.D.
Published in Foot and Ankle International, April 1999
236 patients in 15 Foot and Ankle Centers across the country were evaluated to determine the best and most cost-effective initial treatment of proximal plantar fasciitis.
Patients were divided into five groups. Each group performed Achilles Tendon and Plantar Fascia stretching in a similar manner. One group followed only a stretching program. The other groups each used a different orthotic device including: 1) Tuli Heel Cup; 2) Bauerfeind ViscoSpot; 3) Custom polypropylene medial longitudinal arch support; 4) Hapad Comforthotic.
After 8 weeks of treatment, the patients were reevaluated. The Bauerfeind ViscoSpot used in combination with stretching exercises was the most effective treatment tested, with a 95% success rate. Scores for other methods included: Tuli 88%; Hapad 81%; Stretching alone 72%; Custom orthotic 68%.
The Bauerfeind ViscoSpot was proven the best of all over-the-counter devices tested.
The Bauerfeind ViscoSpot was rated more effective for the initial treatment of heel pain than a custom-made polypropylene orthotic costing $300-$400.
Results showed that using the Bauerfeind ViscoSpot or other prefabricated insert along with stretching exercises was better than stretching alone or using a custom orthosis along with stretching.
The authors concluded that, when used with a stretching program, a prefabricated shoe insert is more likely to produce improvement in symptoms as part of the initial treatment of proximal plantar fasciitis than a custom polypropylene orthotic device.
