Effectiveness of Rocker Sole Shoes in the Management of Chronic Low Back Pain

The authors conducted this study to compare the effectiveness of rocker sole footwear to traditional flat sole footwear as part of the management for individuals presenting low back pain (LBP). Over the last ten years, relentless advertising has claimed that footwear constructed with a rocker sole will reduce LBP.  However, there is no strong evidence to support these claims. 115 people with chronic LBP were randomly selected to wear a rocker sole shoe or a flat sole shoe for at least two hours every day while standing and walking. Primary outcome was the Roland Morris Disability Questionnaire (RMDQ). In addition, participants participated in an exercise and education programme once a week for four weeks and wore their assigned shoes during these sessions. Participants were assessed without knowledge of group allocation pre-randomisation, and at six weeks, six months and one year (main outcome point). Analysis was by intention-to-treat. At 12 months, data from 44/58 (77·2%) of the rocker sole group and 49/57 (84·5%) of the flat sole group was available for analysis. In the rocker sole group, mean reduction in RMDQ was -3.1 (95% C.I -4.5 to -1.6) and in the flat sole group -4.4 (95% C.I -5.8 to -3.1) (a greater negative value represents a greater reduction in disability). At six months, more people wearing flat shoes compared to rocker shoes demonstrated a minimal clinically important improvement in disability (53.2% and 31.1% respectively, p = 0.03). Between-group differences were not significant for RMDQ or any secondary outcomes (e.g. pain) at any time. People reporting pain when standing and walking at baseline (n = 59) reported a greater reduction in RMDQ at 12 months in the flat sole group (-4.4 (95% C.I -6.0 to -2.8), n = 29)) than the rocker sole group (-2.0 (95% C.I -3.6 to -0.4), n = 30)) (p < 0.05).

The study found that rocker sole shoes do not seem to be any more beneficial than flat sole shoes in affecting disability and pain outcomes in people with CLBP. They went even further to say that flat shoes are more beneficial for LBP exacerbated by standing or walking.