By Lisa Rapaport
(Reuters Health) – Mass-produced shoe inserts available on drugstore shelves and customized orthotics may not work for plantar heel pain, a research review suggests.
Plantar heel pain is one of the most common foot ailments, accounting for about 15 percent of foot symptoms requiring medical attention and 10 percent of running injuries, researchers note in the British Journal of Sports Medicine. Many doctors recommend shoe inserts to ease this pain by supporting the arches and taking pressure off the heel, but research to date has been inconclusive about the effectiveness of this approach.
For the current study, researchers examined data from 20 previously conducted experiments that randomly assigned some participants to wear shoe inserts and other participants to join a control group receiving no treatment, a sham insert or a different intervention.
Altogether they tested eight different custom or mass-produced shoe inserts.
Short-term pain relief was similar with and without shoe inserts, and there wasn’t any difference between pre-fabricated models and custom versions, the study found.
“A patient might still prefer to try an orthotic and based on this study, could try a cheaper orthotic first as opposed to a more expensive one, which is custom made,” said lead author Nadine Rasenberg of Erasmus Medical Centre Rotterdam in the Netherlands.
While shoe inserts might be better than nothing, the current study wasn’t designed to answer this question, Rasenberg said by email.
“Most patients prefer to try an intervention as opposed to a `wait and see’ approach,” Rasenberg added. “It remains unknown, whether orthotics are better than doing nothing.”
Orthotics did appear slightly better than sham inserts in the current study, but the difference was too small to rule out the possibility that it was due to chance.
This suggests that orthotics might work for some people, but not others, said Glen Whittaker, a podiatry researcher at La Trobe University in Victoria, Australia, who wasn’t involved in the study. More research is still needed to determine who might benefit, and under what circumstances, Whittaker said by email.
“Appropriately contoured foot orthoses may reduce plantar heel pain by redistributing pressure away from the bottom of the heel to the arch, and may also prevent the arch from dropping, which may reduce tension in the plantar fascia,” Whittaker said.
One limitation of the current study is that it examined results from many small experiments with different methods for testing the effectiveness of orthotics. The small studies also differed in duration and how they assessed pain relief.
Even though they’re widely used, orthotics aren’t the only option for plantar heel pain, said Dr. Selene Parekh, a researcher at Duke University in Durham, North Carolina and partner in the North Carolina Orthopedic Clinic.
Patients can also try night splints or stretching exercises done at home or as part of a supervised physical therapy program, Parekh, who wasn’t involved in the study, said by email. Modified exercise and activity habits may also help avoid irritating the tissues around the heel that cause pain.
If they choose orthotics, patients should look for the cheapest option.
“It seems that patients can attempt to provide some relief to their plantar heel pain using cheaper, readily available orthotics found in grocery stores, online, and stores in their community,” Parekh added. “Based on this study, it appears that the cost of a custom orthotic, which can reach hundreds of dollars, is not medically necessary.”
SOURCE: http://bit.ly/2puzUbm British Journal of Sports Medicine, online March 19, 2018.
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By Jon Herskovitz
PFLUGERVILLE, Texas (Reuters) – The quiet, home-schooled son of a local couple that sold Amway products is suspected of staging a three-week deadly bombing campaign that gripped the Texas capital of Austin.
An arrest warrant and federal criminal complaint identified the maker of the homemade bombs as Mark Conditt, 23, of the Austin suburb of Pflugerville, Texas, law enforcement said on Wednesday.
Conditt, who in 2017 moved out of the Pflugerville home owned by his parents, Danene and William Conditt, blew himself up on Wednesday as police closed in on him.
Attempts to contact members of the Conditt family by telephone and at their homes in Pflugerville were unsuccessful.
Unemployed Mark Conditt was living with a couple of roommates in a home just hundreds of yards from the mayor of Pflugerville when a three-week series of explosions rocked the community, killing two people and injuring five others, public records show.
Conditt attended Austin Community College from 2010 to 2012 but did not graduate, school spokeswoman Jessica Vess said in an email.
As part of a U.S. politics class, students were required to create a blog about their own views on topics such as abortion, same-sex marriage and contraception, classmate Juliana Solitro told Reuters.
Conditt’s six posts on his “Defining my Stance” blog in 2012 included arguments in favor of the death penalty and against same-sex marriage, which at the time was legal in only a handful of states.
“Homosexuality is not natural,” Conditt wrote. “Just look at the male and female bodies. They are obviously designed to couple … it is not natural to couple male with male and female with female. It would be like trying to fit two screws together and to [sic] nuts together.”
He described himself as a conservative but said he was not politically inclined. He said he enjoyed “cycling, parkour, tennis, reading and listening to music.”
Conditt had amassed 30 hours of college credit when he received his high school diploma, having been home-schooled with his three siblings, his mother wrote on Facebook.
“But he’s thinking of taking some time to figure out what he wants to do … maybe a mission trip,” Danene Conditt wrote on Facebook.
Delton Southern, who said Conditt frequented his local Delton’s barbershop for years, described him as “a quiet guy.”
Neighbors said the Conditt family, who live in a neat white house with a blue picket fence around the front porch, was quiet and the parents sold products for Amway, the direct-sales household and personal care items company.
“They are a really nice, calm family,” said retiree Jeff Reeb, who lives next door. “They have always been extremely nice.”
(Additional reporting by Jonathan Allen in New York; Writing by Barbara Goldberg; Editing by Jeffrey Benkoe and Susan Thomas)
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By Jonathan Spicer and Jason Lange
WASHINGTON (Reuters) – The Federal Reserve raised interest rates on Wednesday and forecast at least two more hikes for 2018, signaling growing confidence that U.S. tax cuts and government spending will boost the economy and inflation and lead to more aggressive future tightening.
In its first policy meeting under new Fed chief Jerome Powell, the U.S. central bank indicated that inflation should finally move higher after years below its 2 percent target and that the economy had recently gained momentum.
The Fed also raised the estimated longer-term “neutral” rate, the level at which monetary policy neither boosts nor slows the economy, a touch, in a sign the current gradual rate hike cycle could go on longer than previously thought.
“The economic outlook has strengthened in recent months,” the Fed said in a statement at the end of a two-day meeting in which it lifted its benchmark overnight lending rate by a quarter of a percentage point to a range of 1.50 percent to 1.75 percent.
Inflation “is expected to move up in coming months and stabilize” around the Fed’s target, it said.
Powell, who took over from former Fed chief Janet Yellen in early February, is due to hold a press conference at 2:30 p.m. EDT (1830 GMT).
The rate hike was widely expected. All 104 economists polled by Reuters from March 5-13 said the Fed would increase borrowing costs this week.
Stocks extended gains after the Fed decision while the dollar fell. U.S. Treasury yields initially rose before falling back to levels before the release of the statement.
“The Fed is still expecting three rate hikes this year,” said Lindsey Bell, investment strategist at CFRA Research.
CONFIDENCE IN THE ECONOMY
The move was the latest step away from years of stimulating the world’s largest economy in the wake of the 2007-2009 financial crisis and recession. The Fed tightened policy three times last year.
The combination of $1.8 trillion in expected fiscal stimulus and recent hints of price and wage pressures had prompted some Fed officials to speculate more Americans could be drawn into an already tight labor market and that inflation could rise to the target, or even well above if the economy got too hot.
Policymakers were largely split on Wednesday as to whether a total of three or four rate hikes would be needed this year. They predicted rates would rise three times next year and two times in 2020, a further indication of confidence in the economy.
They projected U.S. economic growth of 2.7 percent in 2018, an increase from the 2.5 percent forecast in December, and also marked up growth for next year. The Fed’s preferred measure of inflation was expected to end 2018 at 1.9 percent, unchanged from the previous forecast, but it is seen rising a bit above the Fed’s target next year.
The U.S. unemployment rate by the end of 2018 is expected to edge down to 3.8 percent, indicating the Fed sees more room for the labor market to run. Fed officials predicted the rate also would settle even lower at 4.5 percent in the longer run.
U.S. joblessness stood at 4.1 percent last month.
While recent home sales and retail spending data have been on the weak side, the overall economic picture has brightened after growth accelerated to 2.3 percent last year.
Before the meeting, analysts were split over whether the Fed, which is wary of an early misstep under its new leadership, would raise policy tightening expectations until more price pressures are clearly evident. There are also looming outside risks to the economy such as a possible global trade war.
(Reporting by Jonathan Spicer; Editing by Paul Simao)
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