The role of foot support use in osteoporotic patients with foot pain, balance instability and mobility impairment: a randomized clinical trial OBJECTIVE: To evaluate the role of foot insoles to maintain the medial arch and forefoot transverse arch in osteoporotic patients with foot pain, balance instability and mobility impairment. METHODS: This was a randomized controlled clinical trial of 94 older women with osteoporosis aged >60 years at the rheumatology clinic at Campinas State University Pre-treatment and 4 weeks post-treatment were assessed using the Timed Up and Go Test (TUG), Manchester’s Foot Pain and Disorders Index (MFPDI) and the Numerical Pain Scale (NPS). The chi-square test, Fisher’s test of significance and Mann-Whitney test were compared between the two groups. Tukey’s multiple comparison test and contrast curve test followed by ANOVA for repeated measures were used for comparison of longitudinal bow measures. For numerical variable relationship analysis, Spearman’s correlation coefficient was used. RESULTS: Only the treatment group showed improvements in balance (BBS and TUG), foot pain (NPS), and mobility impairment (MFPDI) (p < 0.001). Orthopedic insoles can be used as an adjunct to improve balance and prevent falls in middle-aged and older adults.