UPFRONT | Roundup PAIN MANAGEMENT Take 5 Orthotics, chiropractic combo reduce low-back pain: study Shoe orthotics alone or com-bined with chiropractic care can significantly improve low back pain experienced by millions of Americans, according to a new study conducted by National University of Health Sciences (NUHS). The research, published on-line in the Archives of Physical Medicine and Rehabilitation, is said to be the first large-scale study to assess the effectiveness of shoe orthotics for back pain, instead of just foot pain, accord-ing to a statement from the NUHS. In a six-week randomized controlled trial, researchers di-vided 225 adult subjects into three different groups. The con-trol group received no care. Another group received cus-tom-made shoe orthotics and a third received custom-made shoe orthotics plus chiropractic care that included adjustments, hot or cold packs, and manual soft tissue massage. The re-search study exclusively utilized shoe orthotics from Foot Levelers. The results showed that al-though all groups demonstrated pain improvement in six weeks, only the patients using shoe or-thotics had statistically signifi-cant improvements in both function and pain, the NUHS said. “Chiropractic physicians have long prescribed custom shoe orthotics to their patients with the thought that back pain treat-ment might work best when addressing not only the back but also the hips, knees, ankles, and/or feet,” said Dr. Jerrilyn Cambron, the principal investi-gator of the study, a chiropractor and a research professor and www.canadianchiropractor.ca chair of the NUHS College of Allied Health Sciences and Distance Education. “This newly published clinical trial demon-strates that shoe orthotics plus chiropractic care may be a high-ly effective treatment combina-tion.” The study used custom shoe orthotics from Foot Levelers, specifically designed to improve function of the lower extremities and low back. Pain can be caused by a disruption of the kinetic chain, an engineering concept used to describe the way segments of the body are connected. Such a disruption can move from the feet up to the low back, or from the low back down to the feet, the NUHS statement indicated. Cambron believes the study will encourage further research into the way functional shoe orthotics can help improve oth-er complex joint issues such as knee and hip pain. Back pain, now considered a global epidemic, continues to affect about 80 per cent of the population. Meanwhile, wide-spread opioid addiction has caused physicians to limit the amount of opioids they pre-scribe to relieve pain. “For those looking to avoid over-the-counter pain medica-tion and opioids, shoe orthotics combined with chiropractic care may be an alternative worth considering,” Cambron said. “NUHS is proud to lead the research of non-invasive treat-ments for low back pain,” said NUHS president Dr. Joseph Stiefel. “This major study may encourage health-care provid-ers to offer new approaches to low back pain so common among their patients.” WHAT’S ONLINE Canadianchiropractor.ca Canadian Chiropractor offers a lot more content on its website. Check out some of these pages the next time you go online. Reporting on the latest developments in health care as well as trends in practice News Video Job board Looking to hire or want to make a career change? Check out the online job board for the latest opportunities or post your job for free. Watch short features, practice advice and event highlights from the video archive Illustration: Brian Fray October 2017 Canadian Chiropractor 9
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