Walking shoes, sneakers

Beating Osteoarthritis Knee Pain: Beyond Special Shoes

We have plenty of fairy tales about shoes that work magic in people’s lives: glass slippers that brought love to Cinderella, and sparkly red heels that gave Dorothy powers in MGM’s version of The Wizard of Oz.

In real life, footwear magic is limited to “unloading” shoes that may help relieve knee pain from osteoarthritis. These unloading shoes have stiffer soles, and slightly tilted insoles that reposition the foot, intended to reduce (or unload) strain on the knee. But a study published online July 12, 2016, in Annals of Internal Medicine suggests that unloading shoes are no better than a good pair of walking shoes at making pain disappear.

About the study

Researchers randomly assigned 164 people with knee arthritis (age 50 or older) to wear either new unloading shoes or new conventional walking shoes every day for six months. By the end of the study, it appeared that both types of shoes were equally effective at reducing pain and improving physical function, with pain reduced an average of about 25%, and function improved by about 22%. It didn’t prove that both shoes are equally effective, but an editorial accompanying the study says the findings highlight “the promise of simple biomechanical interventions” to address knee pain.

Both shoes used in the study cost $180. But custom-made unloading shoes, and even custom-made insoles that can be inserted into a shoe, can cost many hundreds of dollars.

What to look for in a walking shoe

If you’re going to try a walking shoe to reduce your knee pain, look for certain features, such as:

  • a “stability-type” sneaker with a rigid sole and supportive insole
  • a slightly curved “rocker” sole that helps distribute the body more weight evenly as you walk. This sole may not be right for you if you have balance problems.

And remember that fit is important, too. Seek out:

  • a wide, roomy toe area (what shoe salespeople call the toe box)
  • length at least half an inch beyond your longest toe
  • a sturdy area around your heel (called a heel counter), so your foot stays in place and doesn’t slip around, which can cause friction and pain.

“Most of the sneaker brands make this shoe (New balance, Brooks, Saucony, Asics), so they are widely available. The take home here is that any supportive, rocker-bottom type shoe makes walking with knee osteoarthritis easier,” says Dr. Holly Johnson, an orthopaedic surgeon and instructor at Harvard Medical School. “The other important thing is that keeping physically active is so crucial to bone and joint health. If the shoes make people feel better when they walk, and therefore they walk more, this leads to so many health benefits. Find something comfortable and go with it.”

Other options

Walking shoes aren’t the only way to relieve knee pain without surgery. “I see success stories without surgery every day,” says Dr. Clare Safran-Norton, Clinical Supervisor of Rehabilitation Services at Harvard-affiliated Brigham and Women’s Hospital.