Atta Taseh, Samir Ghandour, Bedri Karaismailoglu, Kendal Toy, Soheil Ashkani-Esfahani, Adam Landsman
Acta Orthopaedica et Traumatologica Turcica - 2025;59(6):374-378
Objective: Arch support insoles are among the first-line conservative treatments for patients with metatarsalgia. This study aims to examine the clinical effect, along with the associated radiologic changes in foot alignment, among metatarsalgia patients with and without the use of arch support insoles. Methods: In this clinical trial, 14 patients with metatarsalgia aged 18 to 65 years were recruited. Pain intensity was obtained at the first visit and after 4, 8, and 12 weeks. All participants underwent bilateral weight-bearing computed tomography (WBCT) and weight-bearing (WB) radiographs of their feet while standing barefoot and on non-custom-made insoles. Several linear and angular radiological measurements were conducted and compared between the barefoot and insole conditions. Interobserver reliability was calculated (intraclass correlation coefficient [ICC]), and the groups were compared using P < .05 as the statistical significance threshold. Results: A total of 14 patients, consisting of 6 females and 8 males, participated in the study. Patient-Reported Outcomes Measurement Information System Pain Intensity scores showed significant improvement starting from the 8th week (P = .04). Weight-bearing radiographic measurements showed significant decreases in the M2-M3 and M2-M5 tangent angles (P = .04 and .03, respectively). Similarly, the M4-M5 intermetatarsal angle decreased when wearing insoles (P = .01). There were no significant changes in the WBCT measurements. Conclusion: Arch support insoles significantly improved pain in patients with metatarsalgia. This symptomatic relief coincides with immediate radiologic changes, mainly in the forefoot area. Future prospective studies with larger populations are suggested to investigate the effects of these insoles on metatarsalgia with various foot types. Level of Evidence: Level IV, Therapeutic study.
