Stepping towards relief: a scoping review on the impact of unstable footwear in chronic low back pain management

INTRODUCTION: Chronic low back pain (CLBP) is a prevalent condition causing significant disability worldwide. Traditional treatments often have limited effectiveness, prompting research into alternative, non-invasive interventions. This review examines the impact of unstable footwear on CLBP management, exploring its potential to reduce pain and disability. EVIDENCE ACQUISITION: We analyzed randomized controlled trials focusing on adults with CLBP. Studies comparing unstable footwear to standard care or conventional footwear were included. Main outcomes measured were pain reduction, functional improvement, and biomechanical changes. Methodological quality was assessed using the PEDro scale. EVIDENCE SYNTHESIS: Five studies met the inclusion criteria, showing a consistent trend towards pain reduction in participants using unstable footwear. Specifically, intervention groups reported significant improvements in pain levels and, in some cases, disability scores compared to control groups. However, findings on functional performance and long-term effects were mixed, with no significant differences in certain studies. Methodological quality varied, with an estimated PEDro score range of 6-7 across the reviewed studies. CONCLUSIONS: Unstable footwear may offer a beneficial non-invasive intervention for individuals with CLBP, contributing to pain reduction and possibly improving disability. Nonetheless, the evidence is tempered by methodological limitations and the need for further research. Future studies should focus on long-term outcomes, larger sample sizes, and clarifying the mechanisms behind the observed benefits. Clinicians should consider unstable footwear as part of a personalized treatment plan for CLBP, keeping abreast of new research to inform their practice.