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The Use of Orthotics in the Reduction of Self-reported Pain Scores in a Veterans Affairs Population: a Retrospective Study

Journal: The AAO Journal Date: 2013/09, 23(3):Pages: 9-12, type of study: retrospective study

Free full text   (https://www.academyofosteopathy.org/aaoj)

Keywords:

heel lifts [3]
leg length inequality [10]
low back pain [413]
sacral base unleveling [3]
retrospective study [213]

Abstract:

Object. Musculoskeletal pain can be the result of postural asymmetry with an unlevel sacral base. Here, the author describes experience with the use of orthotics to reduce self-reported musculoskeletal pain scores after leveling the sacral base in a Veterans Affairs population. Methods. A retrospective review of self-reported pain scores in patients with musculoskeletal pain and sacral base unleveling who received orthotic correction in the author’s clinic between June 2009 and September 2012. Patients first received a temporary heel lift and then custom-molded orthotics (CMOs). Patients who were lost to follow-up, or who were completely noncompliant were excluded from the original analysis, leaving a sample size of 111 patient self-reported pain scores. Data were analyzed through chisquare and t-test evaluations. Results. The average pretreatment pain score (out of 10) was 7.07, falling to an average post-treatment level of 2.52. Eighty-seven percent of patients demonstrated compliance with the treatment prescribed, and among these patients pain scores improved 67.7% from initial heel lift placement to follow-up after treatment with CMOs. Patients who used the prescribed orthotics only intermittently showed a 41% improvement in symptoms. Examination of subjective pre- and post-treatment pain scores demonstrated a positive relationship to the improvement of pain (p = 5.10-34) with the initial use of heel lifts followed by the use of CMOs. Conclusions. The results of this review indicate that the use of heel lifts and custom orthotics in appropriate patients to level the sacral base correlates to a statistically significant decrease in average self-reported musculoskeletal pain scores post-treatment.


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