Orthotics: Prefab or Custom-Made?

If you take a simple stroll down the foot product isle at your local drug store you will find an array of foot products and inserts. You will find inserts for cushion, for comfort, for support and for control. Many questions may cross your mind. What are the differences? Is the $15 insert better than the $7 insert? Are these orthotics? Will they help my foot pain? You may take the time to study the package details closely, but in most instances it doesn't really matter which pair you grab. Most of the inserts at the local drug store are essentially the same.

An insert slips into the shoe and will give you some comfort, cushion and a little support. In some cases, inserts purchased at the drugstore will help alleviate some arch or heel pain and give relief to sore, tired feet. But, an insert is not an orthotic. Orthotics are devices which fit into the shoe and aid in foot function. The most important difference is an orthotic controls abnormal motion and corrects foot function, while an insert will only provide cushion and comfort.

A prefabricated orthotic is a device that is pre-made and designed to fit the most common foot types. Typically, a prefabricated orthotic needs to be purchased at a sports store and they are more expensive than inserts, costing $25-$30. The prefab orthotic is more rigid than an insert and is designed not only to support the arch, but also to help control motion, which will decrease stress on the tendons and ligaments in the arch. Many individuals will do very well with a prefabricated orthotic. Prefab orthotics generally last for one or two years before replacement is necessary.

A functional custom made orthotic is a device that is even more rigid than a prefab orthotic. The custom made orthotic must be rigid to help control the motion in the foot and add support. If the orthotic is soft, the weight of the body would collapse the device and it would no longer function. A custom made orthotic is not only custom molded to your foot and arch, corrective wedges and covers are built into the device to help with motion control and to improve the mechanics of the foot. Individuals with flatfeet, tendonitis, plantar fasciitis, certain foot deformities, knee, hip and back problems may benefit from custom made functional orthotics. The orthotic should make standing, walking, jogging or running more comfortable. Custom made functional orthotics will generally last 7-12 years before needing to be replaced, and can cost between $300-$600.

Functional orthotics are a successful treatment for many problems affecting the lower extremity. In a recent article in the Journal of the American Podiatric Medical Association, 75% of patients surveyed had good to excellent results using functional orthotics to treat heel pain, arch pain, arthritis, bunions, pain from flatfeet or high arches, knee, hip and back pain. A recent article in USA Weekend magazine stated the opposite. The article referenced a study in Foot & Ankle International in which researchers followed 874 healthy, young Israeli army recruits without foot problems. The recruits were given soft custom, semi-rigid custom, soft prefab or semi-rigid prefab orthotics to wear in their boots during basic training. The researchers found no difference in the development of foot problems between the custom made orthotic group versus the prefab orthotic group. The conclusion from this study is that custom made orthotics will not help prevent foot problems from developing. What is important to understand is this study did not evaluate individuals with foot pain or foot problems. The population evaluated was a group of young, healthy, active individuals without any existing foot problems. Therefore, we cannot conclude from this study that prefab orthotics treat foot conditions better than custom-made orthotics.

Individuals with plantar fasciitis (heel and arch pain) who also have flatfeet usually respond best to custom-made orthotics. Certain types of tendonitis respond well to orthotics and other types require orthotics. Posterior tibial tendonitis is the tearing and inflammation of the tendon that helps to hold up the arch. When this tendon is overstressed by arch collapse it cannot heal. Custom made orthotics are essential in the treatment of this condition.

Individuals with high arches may also require orthotics, but they do not respond as well. Custom made orthotics can help slow the progression of bunions and hammertoes, but they will not prevent this process. Orthotics may help with some pain at a bunion, but they will not "cure" the bunion. When the motion in the foot is contributing to the problem, orthotics are generally recommended. If the foot is stable and does not require support, the bunion, hammertoe, neuroma, tendonitis or even plantar fasciitis may not require custom made orthotics for treatment. These individuals may do well with a pre-fabricated orthotic. If you do not have foot pain or an existing foot condition, a custom made orthotic is not necessary for prevention of foot problems.

A custom made accommodative orthotic is soft and designed to reduce pressure and prevent excess friction. Diabetics can develop numbness and loss of circulation in the feet. This numbness and circulation loss puts them at risk for developing open sores on the feet called ulcerations. To help prevent excess rub and friction in certain areas on the feet, accommodative orthotics are recommended. Diabetics who do not have numbness or circulation loss (as diagnosed by their doctor) do not need to have accommodative orthotics, unless the foot has a deformity, like a bunion or hammertoe, then accommodative orthotics are necessary.

Both types of custom-made orthotics are formed by taking a mold of the foot. A functional orthotic mold is fabricated by wrapping the foot in plaster. The foot is held in a corrected position while the plaster is setting. To obtain an accommodative orthotic mold, the patient steps into a foam box. An impression of the foot in a standing position is then created. The molds are sent to a lab and scanned into a computer. A reverse image is produced and the computer generates an image of the foot in neutral position. The computer adjusts the image based on the corrections recommended. A model of the foot is then cut out, in some cases out of wood. The orthotic material is pressed over the foot model and the orthotic is created. The most common material for a semi-rigid custom made orthotic is polypropylene, but other materials, such as graphite are used. A foam-like material is typically used for custom-made accommodative orthotics.

The bottom line is that if you have foot pain, a foot deformity or condition, let your podiatrist evaluate you and decide if orthotics should be part of the treatment. If your insurance will not cover the orthotics and you cannot afford custom made orthotics, consider trying prefabricated orthotics. If you are looking to help prevent foot problems or looking for some extra support, a prefab orthotics is a good option for you, especially if you are active in sports. If you are just looking for a little extra cushion and comfort, an insert at your local drug store will be your best bet.

Christine Dobrowolski is a podiatrist and the author of Those Aching Feet: Your Guide to Diagnosis and Treatment of Common Foot Problems. To learn more about Dr. Dobrowolski and her book visit http://www.skipublishing.com. For more information on prefabricated orthotics visit http://www.northcoastfootcare.com.

---

Alcohol Rehabilitation Centers - Take An Informed Decision

Alcohol rehabilitation centers in the United States offer a wide... Read More

Arthritis Pain Relief : Questions To Ask Your Healthcare Provider

A great place to begin taking charge of you arthritis... Read More

Pain in the Butt. How to Deal with Hemorrhoids?

This is very sensitive area of your body. Too private.... Read More

Vioxx Recall leads to Vioxx Lawsuits

Vioxx is a nonsteroidal anti-inflammagory drug (NSAID) that reduces inflammation,... Read More

Infants and Acid Reflux

Infant acid reflux is quite common. People of all ages,... Read More

Contact Lenses and Eye Glasses, How is Your Vision?

Notice friends getting contact lenses and pulling out eye glasses?"What... Read More

Bextra Withdrawal Could Be Just the Beginning for Pfizer

The pharmaceutical industry is a tremendously profitable one, as anyone... Read More

Lunesta Revealed: 7 Things You Must Know Before You Buy Lunesta Prescriptions

Lunesta is a newly released sleeping pill. Marketed as a... Read More

The Pain Factor

Last year I told an acquaintance that at the age... Read More

4 Reasons Why You Should Use Canadian Pharmacies

Let's face it: purchasing prescription drugs in the U.S. can... Read More

Medical Billing PDA: 21st Century Convenience for Medical Practices

Medical Billing PDAOne of the first things I notice about... Read More

Curing Lou Gehrigs Disease

ALS is the disease that took the life of the... Read More

Zyprexa - History of the Drug

Since the beginning of mankind, mental illness has played a... Read More

Warning: Taking Bextra May Harm Your Health

Another Vioxx-like occurrence may be on the rise, as warnings... Read More

Zyprexa Lawsuits

Zyprexa is an antipsychotic medication that works by changing the... Read More

Medical Billing Software Takes the Stage

Medical Billing SoftwareThe practice is running smoothly, with patients coming... Read More

Family Healthcare: The Dangers Of A Heart Attack & How To Avoid It

A heart attack happens when the blood supply to part... Read More

Utah Drug Rehab: Searching For A Therapist

Finding the right treatment for any person suffering with a... Read More

Can Mexican Pharmacy Purchases Be Trusted?

Purchasing drugs from a Mexican pharmacy is, for the most... Read More

Relafen: A New Drug with an Old Danger

Individuals who regularly take Relafen (nabumetone) or other anti-inflammatory medications,... Read More

Online Pharmacies Are Becoming Increasingly Popular Due To Their Convenience And Discreetness

Leading online pharmacy companies are providing consumer with a secure,... Read More

?Get Rid of Tendonitis ? Now!? Advice From An Expert?

Tendons are ropes of fibrous tissue that connect muscles to... Read More

High Cholesterol Prescription Medications Can Kill You

The World Health Organization declares that heart disease is the... Read More

Rogue Online Pharmacies: The Internet War Of 2005

Online Pharmacy owners who haven't been working within moral and... Read More

Adaptogens for Life - The Science Behind the Discovery of Adaptogens

Modern civilization has produced an unusually stressful environment to humans... Read More

A Closer Look at Neck Pain Relief

Neck pain afflicts many people at some point in their... Read More

An Introduction to Irritable Bowel Syndrome

Irritable bowel syndrome (IBS) is a very common condition, but... Read More

What You Should Know About Mixing Medications and Diet...

I had a call the other day from a potential... Read More

Who Else Wants General Information on Arthritis?

Today there are about 70 million Americans with arthritis?that's one... Read More

Take Control of Your Doctor: Ten Actions To Get What You Need At Your Next Office Visit

Michael Richardson, MD has some suggestions on maximizing your next... Read More

Technology Over Drugs for Stress Related Tension Disorders

As much as 95% of the population suffers from some... Read More

Pharmaceuticals: The Next Frontier in America?s War on Drugs

America's war on drugs, which has been fought in the... Read More

Buy with confidence at Online Mexican Pharmacy

The foremost benefit of buying prescription medicines and other medical... Read More