JPO Journal of Prosthetics & Orthotics:
July 2012 - Volume 24 - Issue 3 - p 107–110
doi: 10.1097/JPO.0b013e3182627659
Original Research Article
A Cohort-Controlled Trial of Customized Foot Orthotics in Trochanteric Bursitis
Ferrari, Robert MD, MSc (Med) FRCPC, FACP
ABSTRACT: Customized foot orthotics are widely prescribed for patients with lower limb pain from a variety of disorders, but there are few trials demonstrating effectiveness and none for trochanteric bursitis. Sixty-eight consecutive patients presenting with symptoms and findings compatible with a case definition for acute or subacute trochanteric bursitis (pain <3 months, point tenderness along the femoral greater trochanter, and pain on resisted hip abduction) were included in the study. A total of 34 subjects were prescribed a local corticosteroid injection under fluoroscopic guidance (control group), and 34 subjects were prescribed a local corticosteroid injection with the addition of customized foot orthotics (orthotics group). All subjects completed the Oswestry Disability Index at baseline, and the number of subjects using prescribed analgesics for their hip pain was recorded at baseline and at follow-ups of 8 weeks and 4 months. Subjects were asked at each follow-up if they felt they had recovered from their "hip and thigh region pain," with recovery arbitrarily being defined as having pain or symptoms in this region for 1 day per week or less. All subjects who failed to report recovery at 8 weeks underwent a repeat corticosteroid injection. A total of 32 subjects in each group completed the study at 8 weeks, and 30 subjects in each group completed the 4-month follow-up. The 2 groups were well matched in terms of age, sex distribution, duration of pain, unilateral or bilateral nature of bursal involvement, and baseline Oswestry Disability Index score. At 8 weeks, 50% reported recovery in the control group and 75% reported recovery in the orthotics group. The number of subjects who reported recovery at 4 months, however, was markedly different between groups, with only 40% reporting recovery in the control group and 90% reporting recovery in the orthotics group. The control group thus reported a high rate of recurrence of trochanteric bursitis. In a cohort-controlled trial of primary care patients with acute or subacute trochanteric bursitis, the addition of custom-made foot orthotics to local corticosteroid injection appears to improve the short- and long-term outcome, with fewer recurrences.
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