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Short answer: the evidence is mixed. Small studies in knee osteoarthritis found benefits from flat, flexible shoes (Trombini-Souza 2012), but a larger 2021 trial found stable supportive shoes reduced walking pain more (Paterson 2021), and a 2026 hip trial found no difference in walking pain but more side effects with flat flexible shoes (Paterson 2026). Decide with your doctor or physiotherapist.
If you live with arthritis, you have probably heard conflicting advice: some say stiff, supportive shoes, others say go as minimal as possible. The honest answer depends on which joints are affected, the type of arthritis and you as an individual. Here is the evidence, study by study.
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Do barefoot shoes help knee osteoarthritis?
Knee osteoarthritis (OA) is where footwear has been studied most, and the results point in different directions.
- Some evidence for flat, flexible shoes. A randomized trial in older women with knee OA reported improvements in pain and function with a flat, flexible minimalist shoe; it was a single trial (Trombini-Souza 2012). A lab study in the same group measured lower knee joint loading in minimalist footwear during stair descent (Sacco 2012).
- Evidence for supportive shoes. A larger randomized trial of 164 people with medial knee OA found that stable supportive shoes improved walking pain more than flat flexible shoes over six months (Paterson 2021).
So there is no one-size-fits-all answer for knee OA, and the strongest trial so far favoured supportive shoes.
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What about hip and foot arthritis?
Hip osteoarthritis
A 2026 trial of 120 people with hip OA compared stable supportive shoes with flat flexible shoes for six months. There was no difference in walking hip pain. The flat flexible group did better on some symptom and quality-of-life scales, but also had more adverse events (31% vs 12%) (Paterson 2026).
Arthritis in the feet
We have not found good trials of barefoot shoes for arthritis in the small joints of the feet, such as rheumatoid arthritis. A very flexible sole may not suit a painful, swollen forefoot joint, and some people prefer more structure. A wide toe box does leave room for swollen toes or changes in foot shape, which some people find more comfortable. Discuss it with your rheumatologist or podiatrist.
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Practical points if you want to try them
Transition slowly
Moving from cushioned, heeled shoes to flat, flexible ones asks more of your feet, ankles and calves. Transition gradually: start with an hour or two a day and increase over several weeks.
Get the fit right
Your toes should have room to spread without touching the end of the shoe. Our fit guide explains how to measure.
Know what "zero drop" means
Zero drop shoes have a completely level sole, with no raised heel. That is the feature tested, in various forms, in the trials above.
Judge by your own joints
Notice how your joints feel over several weeks, not just on the first day. The trials show responses vary from person to person.
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When to see a professional
This article is general information, not medical advice. If you have been diagnosed with arthritis, talk to your doctor, rheumatologist or physiotherapist before a big change in footwear. Get advice promptly if pain rises sharply, a joint becomes hot or newly swollen, you feel unstable, or new symptoms appear in your feet, knees or hips after changing shoes. They can tell you whether a change of footwear makes sense for you.
FAQ
Can barefoot shoes help knee arthritis?
The research is mixed. Smaller studies found improvements with flat, flexible shoes, but a larger trial found supportive shoes reduced walking pain more (Paterson 2021).
Are barefoot shoes bad for rheumatoid arthritis?
Not necessarily, but a very flexible sole may not suit painful foot joints. Ask your rheumatologist or podiatrist.
How long does it take to get used to barefoot shoes with joint pain?
Plan on several weeks at least, with short periods of wear at first.
Should I talk to my doctor before changing shoes?
Yes, if you have diagnosed osteoarthritis or rheumatoid arthritis.
Sources
- Trombini-Souza F et al. Minimalist footwear vs habitual shoe in knee osteoarthritis: RCT. BMC Musculoskelet Disord. 2012. PubMed 22788574
- Paterson KL et al. The effect of flat flexible versus stable supportive shoes on knee osteoarthritis symptoms: a randomized trial. Ann Intern Med. 2021;174(4):462-471. PubMed 33428439
- Paterson KL et al. Stable supportive footwear for self-managing hip osteoarthritis pain: randomized clinical trial. Ann Intern Med. 2026;179(4):469-477. PubMed 41730219
- Sacco IC et al. Joint loading decreased by minimalist footwear in elderly women with knee OA during stair descent. 2012. PubMed 22076748
Written by Mesut Bozkurt · Updated 2 October 2026
