Shoe insoles (or inserts) are devices placed inside shoes that may vary from over–the–counter foam or rubber inserts to custom made orthotics. The therapeutic objective of shoe inserts is the reduction of back pain. Insoles or heel pads can be used to prevent the tendon from having to stretch fully with each step as normally happens. Insoles are often made of cork, plastic, rubber or a gel-like substance called viscoelastic that's found in brands such as Sorbothane, Airplus and Spenco.

Insoles are flat cushioned inserts that are placed inside the shoe. They are designed to reduce shock, provide support for heels and arches, and absorb moisture and odor. Shoe lifts (or raises) are additions made to the heel or sole of a shoe to increase its height. The therapeutic objective of shoe lifts is to compensate for lower limb length inequality and thereby reduce back pain. Corns may be treated by wearing shoes with increased height or width in the toe area and using cushioned pads and insoles.

Adults with foot pain are likely to initiate self-treatment with magnets based on personal recommendations or belief systems, often without a specific diagnosis or prescription. A study by Mayo Clinic suggested that patients who strongly believed in magnets had pain relief even if they were given false magnets to wear. The insoles studied were the Active Comfort magnetic insole (Spenco Medical Corp.), which has a magnetic foil pad located under the arch of the foot.

The use of magnets to treat medical problems remained popular well into the 20th century. More recently, magnets have been marketed for a wide range of diseases and conditions, including pain, respiratory problems, high blood pressure, circulatory problems, arthritis, rheumatism, and stress.

It is important to note that some of study reviews about the effectiveness of shoe insole/ pad pointed out problems with the rigor of most research on magnets for pain. For example, many of the clinical trials involved a very small number of participants, were conducted for very short durations (e.g., one study applied a magnet a total of one time for 45 minutes), and/or lacked a placebo or sham group for comparison to the magnet group.19,20 Thus, the results of many trials may not be truly meaningful. Most reviews stated that more and better quality research is needed before magnets' effectiveness can be adequately judged.

Clinically, pulsed magnets have been shown effective for treating delayed fracture healing, for reducing pain in various musculoskeletal conditions, and for decreasing edema associated with acute trauma, although other studies have shown no benefit in these situations, little is known about their mechanism of action.

Nother study by Dr. Winemiller et al in 2003 concluded a study and found no significant differences in pain outcomes between the two groups (either shoe insoles containing a magnet or insoles). Both experienced significant improvement in morning foot pain and in enjoyment of their jobs (because of reduced foot pain). A poll taken by the About Guide to Chronic Pain/Back and Neck Injury found that 80% of those using them had no pain relief by such type of shoe insole.

Later the Federal Trade Commission has taken action against spurious claims. Magnetic Therapeutic Technologies, Inc. agreed to stop representing their magnet products, including magnetic knee supports and magnetic sleep pads, as treating and alleviating a variety of medical problems, including cancer, high blood pressure, HIV, diabetic neuropathy, and Multiple Sclerosis.

Walking consists of a complex series of biomechanical events involving triplanar movements of the foot and ankle . A variety of external and internal forces can affect foot function. Shear force is the major cause of tissue breakdown in the insensate foot. Its somewhat true that shoe insole causes a significant reduction in the abnormally high pressures recorded under neuropathic feet, and should provide a useful insole for the management of patients at risk of neuropathic foot ulceration ;especially useful for diabetics foot.

It is believed that a metatarsal shoe pad can help relieve pain beneath the ball of the great toe (sesamoiditis) or beneath the ball of the other toes (metatarsalgie). Made of a felt material or firm rubber, the pad has adhesive on its flat side. Fixed to the insure behind the tender area, the pad shares pressure normally placed on the ball of the foot. This relieves pressure beneath the tender spot.

There's no definitive evidence that magnet therapy relieves pain. Many theories have been proposed as to why magnet therapy may relieve pain. But none of these theories has been scientifically proved. Clinical trials involving magnet therapy have produced conflicting results. Some suggest effective pain relief from magnets, and others report no effect. Examples of products containing magnets include shoe insoles, heel inserts, mattress pads, belts and bracelets. Some of these products can be quite expensive.

There's no evidence that shoe insoles prevent or ease back pain. That's the conclusion of Israeli researchers who reviewed three studies of 2,061 people that compared customized and standard insoles to sham insoles or no treatment for back pain prevention.

The review authors also analyzed three small studies of 256 people that focused on the use of insoles for either prevention or treatment of back pain.

"Doctors and other health professionals should not recommend insoles for prevention of back pain or even for back pain treatment," said review lead author Tali Sahar, of the department of family medicine, at Hebrew University in Jerusalem. "Insoles might be beneficial for prevention or treatment of other disorders, but this was not the topic of our review."

The review findings, which appear in the current issue of The Cochrane Library journal, didn't surprise Dr. Paul Hecht, an orthopedic surgeon at Dartmouth Hitchcock Medical Center.

He thinks insoles are "over-prescribed" but does recommend them to cushion the foot. "I will use them for certain indications but not for back pain," Hecht said. "Do they help some people? Yes. Do they help everybody? No."

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