102 patients with first metatarsophalangeal (MTP) joint osteoarthritis (OA) were randomized to receive individualized, prefabricated foot orthoses or rocker-sole footwear. The purpose of this study was to compare the orthoses and footwear to determine their effects on pain reduction. Findings indicated no significant differences between groups for any primary or secondary measured outcomes. However, the foot orthoses group was observed to wear their orthotics for a significantly longer period of time, more likely to report global improvement in symptoms, and less likely to experience adverse events compared to the rocker-sole footwear group at 12-week follow-up.