This Revolutionary Footwear Could Alleviate Your Low Back Pain

Biomechanical footwear that changes how patients walk is showing remarkable success in reducing knee and back pain, potentially delaying the need for joint replacement surgery by retraining the body’s movement patterns.

At a Glance

• Innovative biomechanical footwear called AposTherapy® is helping patients with knee osteoarthritis and low back pain through specially designed shoes with adjustable pods
• Clinical studies show the therapy reduces pain, improves function, and may decrease the need for surgery and opioid medications
• The treatment works by shifting pressure from painful areas and retraining muscles for healthier walking patterns
• Blue Cross Blue Shield of Massachusetts and UK’s National Health Service are now covering this therapy for eligible patients
• Studies indicate the therapy may be more effective than standard physical therapy for certain patients

How the Biomechanical Approach Works

The innovative treatment uses specialized footwear with adjustable, convex pods placed under the sole. These pods alter foot pressure points to reduce load on painful areas and promote better neuromuscular control during walking. Unlike traditional therapies requiring dedicated exercise time, this approach integrates treatment into everyday activities as patients simply wear the shoes while going about their normal routines.

“If you’ve ever watched somebody who has pain — whether it’s knee pain, hip pain, back pain — they walk a little strange,” says Matthew Bartels, MD, MPH.

The therapy, which has been cleared by the FDA for treating knee osteoarthritis and other musculoskeletal conditions, combines a patented medical device with a personalized treatment program addressing the underlying causes of pain. Each pair of shoes is calibrated to the individual patient’s specific needs, creating a more balanced walking pattern that reduces pressure on affected joints and realigns the body’s mechanics.

Clinical Evidence for Effectiveness

AposTherapy® has demonstrated impressive results in multiple studies. A randomized controlled trial showed greater reduction in pain scores for those using the shoe intervention compared to those receiving traditional physical therapy. Participants also reported better outcomes in function scores, walking speed, and overall quality of life measurements.

“We all know that if you have knee or back pain, physical therapy will make you better, but the problem is, people don’t keep the exercises up,” notes Matthew Bartels, MD, MPH.

Perhaps most significantly, a retrospective registry review indicated a lower percentage of knee replacement surgeries among patients using the shoe intervention compared to those receiving standard physical therapy. This suggests the therapy may help reduce healthcare burdens by delaying or even eliminating the need for surgical interventions in some patients. Over 70,000 patients worldwide have used the therapy, with consistently high satisfaction rates reported.

Insurance Coverage and Accessibility

As evidence mounts for the effectiveness of this approach, insurance providers are beginning to cover the treatment. Blue Cross Blue Shield of Massachusetts launched a pilot program offering the therapy to commercial, fully insured members without requiring a prescription or prior authorization. This represents a significant shift toward making innovative non-surgical treatments more accessible to patients seeking alternatives to pain medications or surgery.

“We know many of our members suffer with knee, hip and low back pain, and they want surgery to be a last resort,” says Bruce Nash, MD, chief physician executive at Blue Cross Blue Shield of Massachusetts.

In the United Kingdom, where over 20 million people suffer from musculoskeletal conditions, the National Institute for Health and Care Excellence (NICE) has recommended the therapy. Starting April 2024, the UK’s National Health Service will cover Apos® under its MedTech Funding Mandate policy, which supports technologies that are NICE-recommended, cost-saving, and offer a return on investment within three years.

Expert Perspectives and Patient Considerations

Medical experts suggest the therapy may be particularly beneficial for certain patient populations. Those who have tried exercise and medication interventions without success and who maintain a moderate level of physical activity may be good candidates. The therapy addresses fundamental biomechanical issues that other treatments may not target as effectively.

“Apos Therapy doesn’t just treat the symptoms of pain, it treats the causes of pain – without painkillers or invasive procedures or requiring patients to change their daily routines,” explains Dr. Cliff Bleustein, global CEO and president of AposTherapy.

However, experts also caution that the approach may not be suitable for everyone. “For a specific type of patient that has tried exercise interventions, has tried medication interventions, and a combination of both, that has a decent amount of physical activity, it may be something to explore, particularly to maintain neutral balance or create a better line through the foot,” says Garrett Bullock, PhD, DPT.

The expanding availability of innovative biomechanical approaches represents a promising development for the millions suffering from chronic joint pain, potentially offering an effective non-surgical option that integrates seamlessly into daily life while addressing the root causes of pain.