Special shoes designed to change how people walk could be the key to reducing back pain and postponing knee replacement surgery, giving new hope to millions who suffer from these common conditions.
At a Glance
- The innovative footwear system, AposTherapy®, uses adjustable pods under the sole to alter foot pressure points and retrain walking patterns
- Clinical studies show the therapy reduces pain, improves function, and may decrease the need for surgery more effectively than standard physical therapy
- Blue Cross Blue Shield of Massachusetts and the UK’s National Health Service are now covering this non-surgical treatment option
- Over 70,000 patients worldwide have used the therapy, which is FDA-cleared for treating knee osteoarthritis and other musculoskeletal conditions
- The intervention works by addressing the cause of pain rather than just symptoms, potentially reducing healthcare costs by delaying surgery
How the Footwear Technology Works
Unlike traditional treatments for musculoskeletal pain that focus on managing symptoms, this innovative footwear technology aims to correct the underlying biomechanical issues. The system, known as AposTherapy®, features specially designed shoes with adjustable, convex pods positioned strategically under the sole. These pods shift pressure away from painful areas while simultaneously retraining muscles to create healthier walking patterns that reduce stress on joints and the lower back.
The therapy is personalized for each patient’s specific gait problems and pain locations. By wearing the shoes for approximately one hour daily during normal activities, patients effectively receive continuous, passive physical therapy. This approach addresses a common problem with traditional physical therapy – inconsistent patient adherence to prescribed exercises.
“If you’ve ever watched somebody who has pain — whether it’s knee pain, hip pain, back pain — they walk a little strange,” explains Matthew Bartels, MD, MPH. “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.”
Research Shows Promising Results
A randomized controlled trial, presented at the recent American Academy of Physical Medicine and Rehabilitation Annual Assembly, demonstrated that patients using the shoe intervention experienced greater reductions in pain compared to those receiving traditional physical therapy. Additionally, those using the specialized footwear showed more significant improvements in function scores, walking speed, and overall quality of life measures.
Perhaps most compelling is data from a retrospective registry review indicating that patients who used the footwear intervention had a substantially lower rate of knee replacement surgeries compared to those who received traditional physical therapy. This suggests the approach may effectively delay or even prevent the need for invasive surgical procedures in some patients.
“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,” states Dr. Cliff Bleustein, global CEO and president of AposTherapy.
The treatment has already been used by over 70,000 patients worldwide, with reports of high satisfaction rates. For those suffering from chronic knee or back pain who have tried medication and exercise without sufficient relief, this non-invasive approach offers a promising alternative before considering surgical options.
Insurance Coverage Expands Access
As evidence for the effectiveness of this approach grows, insurance coverage is expanding. Blue Cross Blue Shield of Massachusetts has launched a pilot program covering the therapy for their commercial, fully insured members without requiring a prescription or prior authorization. The program is specifically targeting members suffering from knee osteoarthritis and chronic low back pain.
“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. Beginning April 2024, it will be covered under NHS England’s MedTech Funding Mandate policy, which supports technologies that are both clinically effective and cost-saving. This expanded coverage aims to ensure faster and more equitable access to this treatment option across the UK.
Who Might Benefit Most
While the therapy shows promise, experts note it may not be appropriate for everyone with joint or back pain. The intervention appears most beneficial for patients who have already tried exercise and medication interventions without adequate relief, particularly those who maintain a moderate level of physical activity. The therapy is FDA-cleared for treating knee osteoarthritis and has shown effectiveness for certain types of low back pain as well.
“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,” advises Garrett Bullock, PhD, DPT.
This innovative approach may offer particular benefits for populations disproportionately affected by musculoskeletal conditions, including those in areas with higher rates of poverty. By providing an at-home, non-pharmaceutical pain management option, the therapy could help reduce healthcare disparities while potentially decreasing overall healthcare costs by delaying or preventing more expensive surgical interventions.
