- Scientists find that supportive shoes may not reduce hip arthritis pain as previously thought.
- In a recent study, researchers found that footwear on its own probably won’t make a big difference in hip arthritis symptoms.
- Podiatrists share the best shoes for foot pain and explain the study findings.
Most joint pain experts will tell you that shoes for arthritis need to be cushioned and supportive. That’s the standard recommendation for all types of lower extremity arthritis, including arthritic hip pain, says Bobby Pourziaee, D.P.M., a board-certified foot and ankle surgeon at Rodeo Drive Podiatry. But scientists found that the type of shoe that’s best for people with hip arthritis may be another type of shoe.
For the study, published in Annals of Internal Medicine, researchers randomly split 120 people with hip arthritis pain into two groups of 60. One group wore flat, flexible shoes (i.e., a ballet flat or slide sandal) and the other wore more stable, supportive shoes (like cushioned sneakers or insoles) over six months for six hours per day.
Meet the experts: Bobby Pourziaee, D.P.M., a board-certified foot and ankle surgeon at Rodeo Drive Podiatry; Ashley Katzenback, P.T., D.P.T., doctor of physical therapy in Cape Cod; and Samantha Landau, D.P.M., assistant professor at Touro University New York College of Podiatric Medicine
Scientists measured participants’ pain, symptoms, daily functioning, ability to do sports and recreational activities, quality of life, physical activity levels, overall improvement, and any negative side effects. Researchers measured pain using an 11-point scale that ranged from zero to 10, with a higher number indicating more pain. After calculating the average scores from both groups and comparing them, researchers found virtually no difference in pain levels between the two.
These findings suggest that “footwear stiffness and structure alone may not substantially change symptoms for hip arthritis,” explains Dr. Pourziaee. But it’s definitely a conclusion to approach with some skepticism, considering the recommendation of supportive footwear for arthritis is long-established and evidence-based.
“Clinically, many physicians and podiatrists recommend supportive, cushioned footwear for patients with lower extremity arthritis because these shoes can reduce joint loading and improve shock absorption during walking,” says Pourziaee. “However, this study highlights an important nuance: Hip osteoarthritis symptoms may not be as sensitive to footwear structure as foot, ankle, or knee conditions. Hip pain is influenced by multiple factors, including muscle strength, gait mechanics, and joint degeneration—not just shoe design.”
Ashley Katzenback, P.T., D.P.T., a doctor of physical therapy in Cape Cod, MA, adds that she is delighted by the study’s findings. “In my practice, I encourage patients to wear flat, flexible footwear whenever possible so they can feel where their foot is on the ground,” she explains. “Oftentimes, if your shoe is overly cushioned, you will end up taking a longer stride, which changes your gait.”
Essentially, cushioning may change how your heel lands, potentially distributing weight unevenly and resulting in lower-back and hip pain, Katzenback says. “If you have a flexible shoe that allows you to feel the ground, you will be lighter on your feet and take shorter steps, pushing off through your toes and activating your glutes,” she adds. “Your glutes are the strongest muscle in your body and will lengthen your hips.”
What does other science say?
Studies as recently as 2023 support cushioned shoes for arthritic hip pain. However, some of those study participants also had knee arthritis, and so pain management was directed at multiple joints. Even so, Samantha Landau, D.P.M., assistant professor at Touro University New York College of Podiatric Medicine, maintains steadfast concerns about how this study was conducted. She points out that its participants were all lumped under the general diagnosis of arthritic hip pain, despite hip pain being a very broad concept that needs specific evaluation and treatment planning.
“Importantly, the conclusions do not align with typical evidence-based recommendations for arthritis management,” she reiterates. In any patient with degenerative joint disease, Landau typically recommends stable, supportive footwear. “Interestingly, even within the study’s own findings, the stable shoe group demonstrated improvement in foot and ankle pain, likely due to improved gait function,” Landau theorizes. “They also had fewer adverse events.”
What shoes to wear for hip pain
For patients with hip arthritis, Pourziaee generally recommends shoes with:
• Moderate cushioning to absorb ground impact
• Stable midsoles to control excessive motion
• A slight rocker or smooth heel-to-toe transition to reduce joint loading during walking
• Lightweight construction to minimize fatigue
• A wide, comfortable toe box
“Running-style walking shoes often work well because they provide a combination of shock absorption, stability, and efficient forward motion, which can reduce strain,” he explains. Katzenback adds that it may be helpful to visit a physical therapist for a gait evaluation, which can help you land on the best shoe for you. “One of the most important points for patients with arthritis is comfort and consistency,” Pourziaee concludes. “The best shoe is typically the one that allows someone to walk comfortably and stay physically active.”
The bottom line
The main takeaway is that footwear alone is unlikely to dramatically change hip osteoarthritis symptoms. “That’s not entirely surprising because hip arthritis is influenced by muscle strength, joint alignment, body weight, and activity patterns,” says Pourziaee. “Shoes may modify ground forces slightly, but they cannot fundamentally change hip joint degeneration.”
Physical therapy, strengthening exercises, weight management, and activity modification may also play a part in arthritis management, Katzenback adds.
Even so, if you and your providers have found a cushiony shoe that does help your hip pain, by all means, don’t get rid of it. “Footwear prescriptions for hip arthritis must be individualized,” says Landau. “A one-size-fits-all recommendation—especially one that diverges from established arthritis management principles—should be approached with caution.”
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