Short answerProbably not. When wedge insoles were compared with flat insoles, they made no real difference to knee pain.

Evidence grade

Does not helpNot enough evidenceHelps a littleGood evidence

Probably does not help

What it is

Arthritis often wears the inner side of the knee more than the outer side. A lateral wedge insole is a shoe insert that is thicker on the outer edge. It tilts the foot so that less load passes through the inner side of the knee. The idea is that this eases pain.

What the research shows

brought together 12 trials with 885 people who had pain from arthritis on the inner side of the knee. Taken all together, the trials suggested a benefit. But the trials with the best design did not. In seven trials where the comparison was a flat insole, wedges made no difference to pain. The authors concluded that the findings do not support the use of wedge insoles.

The benefit seen when all 12 trials were pooled shrank to nothing in the better designed trials. A flat insole is the fairest comparison, because it controls for the placebo effect. The largest of these was in which 200 people wore a wedged or a flat insole every day for a year. Pain and cartilage loss were the same in both groups. and advise against wedge insoles, and makes a strong recommendation against them.

Risks and effort

Insoles are low risk. Some people find them uncomfortable, and they can change how the foot and ankle feel. They take little effort to try.

What usually works instead

Exercise and strength work for the leg muscles, and weight loss where that applies, have the best evidence. Anti-inflammatory gels and tablets can also help for a while. See Osteoarthritis of the Knee, Does exercise work for knee arthritis? and Do unloader knee braces work for knee arthritis?.

Questions people ask

Does it matter which side of the knee is worn?

These trials were in people with wear on the inner side. Wedge insoles are not suited to arthritis in the kneecap joint or on the outer side.

Could a flat insole help too?

Pain often eases with a flat insole too, because arthritis pain rises and falls and expectation plays a part. That is why the flat insole is the fair comparison.

Are shoes with a softer sole better?

The review also included shoes with variable stiffness soles. Its conclusion did not support wedge shoe treatments in general.

Is there any harm in trying one?

Little harm. If it makes your knee feel better and you like it, there is no strong reason to stop. Do not let it replace exercise.

Sources

Select a source to read what the study or guideline found, in plain words, with a link to the original.

Sources

Meta-analysis

1Pooled analysis of wedge insole trials

Who and when. Researchers at the University of Manchester and Boston University, published in JAMA in 2013.

What they did. They pooled 12 randomised trials with 885 people who had arthritis on the inner side of the knee, comparing a wedged insole with a flat insole or no insole.

What they found. Pooling everything, wedges looked helpful. But the four trials that compared wedges with nothing gave big results, and the seven trials that compared wedges with a flat insole found no difference in pain at all. The better the trial, the smaller the effect.

What it means. When the comparison is fair, wedge insoles do nothing for pain. The apparent benefit in weaker trials is the placebo effect of being given something to wear.

Parkes MJ, Maricar N, Lunt M, LaValley MP, Jones RK, Segal NA, Takahashi-Narita K, Felson DT. Lateral wedge insoles as a conservative treatment for pain in patients with medial knee osteoarthritis. A meta-analysis. JAMA. 2013;310(7):722-730.

Read the summary on PubMed →

Randomised trial

2Melbourne trial of wedge insoles over 12 months

Who and when. The University of Melbourne, published in the BMJ in 2011.

What they did. They gave 200 people aged 50 and over with mild to moderate inner-knee arthritis either a 5 degree wedged insole or a flat insole, to wear every day for a year. Neither the people nor the assessors knew which was which. They measured pain and used MRI to measure cartilage.

What they found. Pain changed by the same small amount in both groups, and cartilage loss was identical. No secondary measure differed either.

What it means. The largest and longest blinded trial found no benefit for symptoms and no slowing of the arthritis.

Bennell KL, Bowles KA, Payne C, Cicuttini F, Williamson E, Forbes A, Hanna F, Davies-Tuck M, Harris A, Hinman RS. Lateral wedge insoles for medial knee osteoarthritis. 12 month randomised controlled trial. BMJ. 2011;342:d2912.

Read the summary on PubMed →

Australian guideline

3RACGP guideline for knee and hip osteoarthritis

Who and when. The Royal Australian College of General Practitioners, with Australian arthritis researchers, second edition 2018. This is the guideline Australian GPs follow.

What they did. An expert panel reviewed the research on each treatment and graded how strongly to recommend it, for or against.

What they found. The guideline conditionally recommends against wedge insoles for knee arthritis.

What it means. Australian GPs are advised not to suggest them.

Royal Australian College of General Practitioners. Guideline for the management of knee and hip osteoarthritis. 2nd ed. East Melbourne: RACGP; 2018.

Read the guideline →

International guideline

4OARSI guideline for non-surgical treatment of knee and hip osteoarthritis

Who and when. The Osteoarthritis Research Society International, the main scientific body for arthritis research, published July 2019.

What they did. A panel of 21 experts from 11 countries reviewed the pooled trial evidence for 60 different treatments and voted on each one.

What they found. Wedge insoles were not recommended for knee arthritis at any level, for any group of patients.

What it means. The international panel found no case for them.

Bannuru RR, Osani MC, Vaysbrot EE, Arden NK, Bennell K, Bierma-Zeinstra SMA, Kraus VB, Lohmander LS, Abbott JH, Bhandari M, Blanco FJ, Espinosa R, Haugen IK, Lin J, Mandl LA, Moilanen E, Nakamura N, Snyder-Mackler L, Trojian T, Underwood M, McAlindon TE. OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis. Osteoarthritis Cartilage. 2019;27(11):1578-1589.

Read the summary on PubMed →

US guideline

5American College of Rheumatology guideline for osteoarthritis

Who and when. The American College of Rheumatology and the Arthritis Foundation, published January 2020. The panel included patients as well as doctors and therapists.

What they did. A literature review team summarised the benefits and harms of every common treatment, and a voting panel graded each recommendation as strong or conditional.

What they found. The panel made a strong recommendation against wedge insoles for knee arthritis, citing the trials above.

What it means. One of the few treatments to get a strong recommendation against.

Kolasinski SL, Neogi T, Hochberg MC, Oatis C, Guyatt G, Block J, Callahan L, Copenhaver C, Dodge C, Felson D, Gellar K, Harvey WF, Hawker G, Herzig E, Kwoh CK, Nelson AE, Samuels J, Scanzello C, White D, Wise B, Altman RD, DiRenzo D, Fontanarosa J, Giradi G, Ishimori M, Misra D, Shah AA, Shmagel AK, Thoma LM, Turgunbaev M, Turner AS, Reston J. 2019 American College of Rheumatology/Arthritis Foundation guideline for the management of osteoarthritis of the hand, hip, and knee. Arthritis Rheumatol. 2020;72(2):220-233.

Read the summary on PubMed →

Last reviewed 24 October 2026. Next review due October 2028.

What it is

What the research shows

Risks and effort

What usually works instead

Questions people ask

Does it matter which side of the knee is worn?

Could a flat insole help too?

Are shoes with a softer sole better?

Is there any harm in trying one?

Sources

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