Innovative footwear technology is giving patients with chronic knee and back pain a chance to avoid surgery and lead more active lives, offering relief through specialized shoes that retrain walking patterns.
At a Glance
- A specialized shoe-based intervention called AposTherapy® reduces back and knee pain by shifting pressure from painful areas and retraining muscle patterns.
- Clinical studies show this FDA-cleared technology can reduce pain, improve function, and decrease the need for opioids and surgery.
- Blue Cross Blue Shield of Massachusetts and the UK’s National Health Service now cover this treatment, making it accessible to more patients.
- Research indicates the intervention may delay or reduce the need for knee replacement surgery compared to traditional physical therapy.
- The device works through adjustable, convex pods under the sole that alter biomechanics during daily activities.
How the Technology Works
The innovative footwear intervention uses specialized shoes with adjustable, convex pods attached to the sole. These pods strategically alter the pressure points on the feet, shifting weight away from painful joints and promoting better neuromuscular control during walking. Unlike traditional physical therapy that requires dedicated exercise time, these shoes work while patients go about their normal daily activities.
“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 from Medscape Medical News.
Called AposTherapy® in the United States and Apos® in the UK, the treatment combines the specialized footwear with a personalized treatment program. After an initial biomechanical assessment, clinicians calibrate the device to address each patient’s specific walking patterns and pain triggers. Patients then wear the shoes for short periods daily, gradually increasing usage as their gait improves and pain decreases.
Clinical Evidence for Pain Relief
Recent clinical studies have provided compelling evidence for the effectiveness of this footwear intervention. A randomized controlled trial demonstrated that patients using the shoe technology experienced greater reductions in pain scores compared to those receiving standard physical therapy. Beyond pain relief, participants also showed improvements in function scores, walking speed, and overall quality of life measures.
“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 technology has gained significant clinical recognition. It’s now FDA-cleared for treating knee osteoarthritis and other musculoskeletal conditions in the US. In the UK, the National Institute for Health and Care Excellence (NICE) has officially recommended the device, confirming it is “clinically proven to relieve pain and improve function in the knees and lower back,” according to documentation from the NHS Supply Chain.
Delaying Surgery and Reducing Healthcare Costs
One of the most promising aspects of this footwear intervention is its potential to delay or even eliminate the need for knee replacement surgery. A retrospective registry review found a lower percentage of knee replacement surgeries among patients using the shoe technology compared to those following traditional physical therapy protocols. This finding has significant implications for patients wanting to avoid surgery and healthcare systems looking to reduce costs.
“We know many of our members suffer with knee, hip and low back pain, and they want surgery to be a last resort,” notes Bruce Nash, MD, chief physician executive at Blue Cross Blue Shield of Massachusetts.
The economic benefits have prompted major insurers to cover the treatment. Blue Cross Blue Shield of Massachusetts launched a pilot program offering the device to members with knee and low back pain without requiring a prescription or prior authorization. Similarly, the UK’s National Health Service will cover Apos® under its MedTech Funding Mandate policy starting April 2024, ensuring wider access to this technology.
Who Benefits Most from This Approach
While the technology shows promise, experts note it may not be appropriate 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,” advises Garrett Bullock, PhD, DPT.
The technology particularly benefits those who struggle with traditional physical therapy adherence. As Dr. Bartels explains, “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,” With over 70,000 patients worldwide having used AposTherapy® with high satisfaction rates, this home-based intervention offers a convenient alternative for chronic pain management without disrupting daily routines.
