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Comparison of Orthotic Materials on Foot Pain, Comfort, and Plantar Pressure in the Neuroischemic Diabetic Foot

A Case Report

Joshua Burns, PhD ^* , Lindy Begg, Dip Pod ^* and Mauro Vicaretti, PhD ^* 

^* Foot Wound Clinic, Department of Podiatry, Westmead Hospital, Sydney, Australia.
Institute for Neuromuscular Research, The Children’s Hospital at Westmead/Discipline of Paediatrics and Child Health, Faculty of Medicine, University of Sydney, Sydney, Australia.
Department of Vascular Surgery, Westmead Hospital, Sydney, Australia; Department of Surgery, Faculty of Medicine, University of Sydney, Sydney, Australia.

Corresponding author: Dr. Joshua Burns, PhD, Institute for Neuromuscular Research, The Children’s Hospital at Westmead, Locked Bag 4001, Westmead, New South Wales, Australia, 2145. (E-mail: joshuab2{at}chw.edu.au)

Abstract

Foot pain and lower-limb neuroischemia in diabetes mellitus is common and can be debilitating and difficult to treat. We report a comparison of orthotic materials to manage foot pain in a 59-year-old man with type 1 diabetes mellitus, peripheral neuropathy, peripheral arterial disease, and a history of foot ulceration. We investigated a range of in-shoe foot orthoses for comfort and plantar pressure reduction in a cross-sectional study. The most comfortable and most effective pressure-reducing orthoses were subsequently evaluated for pain relief in a single system alternating-treatment design. After 9 weeks, foot pain was completely resolved with customized multidensity foot orthoses. The outcome of this case study suggests that customized multidensity foot orthoses may be a useful intervention to reduce foot pain and maintain function in the neuroischemic diabetic foot. (J Am Podiatr Med Assoc 98(2): 143–148, 2008)