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To the Editor: Dr Winemiller and colleagues¹ found that magnetic insoles did not improve symptoms among patients with chronic heel pain. I question the methods used to arrive at this conclusion.

Plantar heel pain is common and has many causes. The ability to distinguish various foot conditions by clinical examination alone can be fraught with error because of symptom overlap and spectrum bias.^2-3 There is no evidence that patients in the study by Winemuller et al had magnetic resonance imaging, radiographs, or nerve conduction studies. There is also no mention of patients' weights, activity levels, or whether or not they had diabetes mellitus.

Plantar fasciitis originates in the calcaneal region. However, in this study the magnetic foil was placed under the proximal arch of the foot and therefore the calcaneal region may not have received magnetic exposure. Because morning pain is an important symptom of plantar fasciitis, it is surprising . . . [Full Text of this Article]

Michael I. Weintraub, MD
Departments of Neurology and Medicine
New York Medical College
Briarcliff Manor

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