TOPLINE:

Stable supportive shoes provided no greater hip pain relief while walking than flat flexible shoes for people with chronic hip osteoarthritis (OA). Both shoe types resulted in pain reductions after 6 months.

METHODOLOGY:

• Researchers conducted a pragmatic, comparative effectiveness, superiority randomized clinical trial in Melbourne, Australia, involving 120 people with chronic hip OA enrolled from January 2022 to November 2023.
• Participants were aged 45 years or older; experienced activity-related hip pain; had no morning stiffness lasting over 30 minutes; rated their pain at least 4 out of 10; and had pain present for at least 3 months, occurring on most days of the previous month.
• Participants were randomly assigned to receive either stable supportive shoes (n = 60; mean age, 59.9 years; 65% women) or flat flexible shoes (n = 60; mean age, 59.7 years; 80% women); each participant chose two pairs from various options and was instructed to wear them at least 6 h/d for 6 months.
• The primary outcome was the 6-month change in self-reported hip pain while walking, measured using an 11-point numerical rating scale (0 = no pain, 10 = worst pain possible), which was completed by 116 participants. The minimal clinically important difference was set at 1.8 points.
• Secondary outcomes included 6-month changes in Hip Disability and Osteoarthritis Outcome Score (HOOS) subscales, pain at other body sites, physical activity levels, and other variables, and the occurrence of adverse events.

TAKEAWAY:

• Stable supportive shoes did not differ significantly from flat flexible shoes in reducing hip pain while walking at 6 months (mean difference [MD], -0.5 point; P = .163).
• Both footwear groups experienced reductions in hip pain from baseline to 6 months, with an MD of 1.9 points for those who wore stable supportive shoes and 2.5 points for those who wore flat flexible shoes.
• On average, the use of flat flexible shoes yielded greater improvements in the HOOS symptom subscale (MD, 6.6 points; 95% CI, 1.4-11.7 points) and the hip-related quality-of-life subscale (MD, 7.8 points; 95% CI, 1.1-14.4 points), but the mean between-group differences did not surpass the nine‑point minimal clinically important difference.
• Adverse events occurred less frequently with stable supportive shoes vs flat flexible shoes (12% vs 31%; relative risk, 0.39; 95% CI, 0.18-0.86), with foot and hip pain reported most frequently.

IN PRACTICE:

“[T]hese findings do not support the use of stable supportive shoes over flat flexible shoes for managing chronic hip osteoarthritis,” the authors of the study wrote. “Our study suggests that footwear that is beneficial for knee osteoarthritis pain might not reduce hip osteoarthritis pain,” they added.

SOURCE:

The study was led by Kade L. Paterson, PhD, University of Melbourne, Melbourne. It was published online on February 23, 2026, in Annals of Internal Medicine along with a Summary for Patients.

LIMITATIONS:

Participants’ baseline expectations could have influenced self‑reported walking pain. The provision of new footwear for both groups may have attenuated between‑group differences. The stable supportive models may not have featured sufficiently pronounced characteristics; thus, more robust designs would yield different results. The study was limited to an Australian community sample, thereby affecting the generalizability to other regions or demographic groups.

DISCLOSURES:

The National Health and Medical Research Council provided funding support. Two authors reported receiving support from Leadership Investigator Grants from the funding source. 

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.