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Do ‘rocker sole’ shoes really help low back pain?

Shoes with ‘rocker soles’ don’t improve low back pain any more than traditional flat-soled trainers, reports a study, calling into question advertising by the manufacturers.

BMJ Group News

What do we know already?


Low back pain is very common, affecting up to 80 in 100 of us at some point in our lives. Usually this pain improves within a couple of weeks, but some people have long-term (chronic) back pain lasting for more than three months.

Many treatments are available for long-term back pain, including back exercises, painkillers, spinal manipulation, and surgery. In recent years, many people have also tried shoes with ‘rocker soles’. These soles are curved, which makes them less stable than standard flat soles. Manufacturers of these shoes say that less stability can help back pain by improving balance, posture, and muscle activity. However, no good research has supported these claims.

Researchers have now done a high-quality study that included 115 people with long-term low back pain. The people were randomly given either rocker sole shoes or trainers to wear for at least two hours each day while standing and walking. Over 12 months, they filled in questionnaires about their back pain, and how much it affected their daily life (their level of disability). The participants also attended a four-week exercise and education programme at the start of the study, in which they wore their new shoes.

What does the new study say?

After 12 months, both groups had similar improvements in their pain and level of disability. However, the improvements in disability tended to come earlier for people wearing trainers, with 53 in 100 people in this group having noticeable improvements after six months, compared with 31 in 100 people in the rocker sole group.

When researchers looked only at people whose pain was made worse by walking or standing, they found that those wearing trainers had more improvement in their level of disability after 12 months than those wearing rocker sole shoes.

There was no difference between the groups in the amount of time people took off work because of back pain, and neither group had any serious problems relating to their shoes.

At both six months and 12 months after the start of the study, people wearing trainers were more likely to be satisfied with their footwear than those wearing rocker sole shoes.

How reliable is the research?

These findings should be reliable. This was a randomised trial, which is the best type of study for comparing treatments. It was also well conducted.

However, we need to be a bit cautious about the results looking at people whose pain was made worse by walking or standing, as these findings were based on only 59 people. This may be too small a group for drawing firm conclusions.

What does this mean for me?

If you have long-term low back pain, this study provides good evidence that wearing rocker sole shoes won’t improve your pain or level of disability any more than wearing traditional trainers. And if you wear trainers, you may actually be able to do more sooner.

Talk to your doctor if your back pain is long-lasting, as there are good treatments that can help lessen your discomfort and allow you to get on with your everyday life.

Published on October 15, 2013

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