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.

---

10 Home Remedies For Arthritis Pain Relief

Your Remedy No. 1 ==============Stretch Gently for Strength and Mobility.When it comes to arthritis, moving hurts, but not moving destroys.Incorrect moving harms, but intelligent moving heals.Yoga teaches movement with proper joint alignment which... Read More

Another Cold Sore! Why Me?

An estimated 85 million Americans have acquired the herpes simplex (cold sore) virus. And the majority had received the virus before the age of 3.Not such a big surprise when you realize how... Read More

Medical Billing Specialist

As Pres. Bush was touring the Midwest, shortly before he was re-elected as President, and even after, he spoke of medical reform centering on liability costs. He called it "defensive medicine." Searching for... Read More

The Highway to Health - Bumped Heads

I recently had a reader send me this comment:"As a full-time dad I have to deal with just about every minor illness my two children pickup, everything from a bump on the head... Read More

7 Tips to Keep Your Fluid Down on Dialysis

As any dialysis patient will tell you, keeping your fluid gain between dialysis sessions in check is not only important to your long term health, it is a major factor in your immediate... Read More

Generic Drugs: How They Cost You Less?

If you are wondering why the chemist has charged much less than what you expected then it is not because he has developed sudden liking for you or the government decided to subsidized... Read More

Bextra, Some Facts To Consider

For those who take Bextra, there are many warnings out that are telling people to stop. It is wise to do this and to do it right away. Of course, you should talk... Read More

The Truth about C Reactive Protein and Cholesterol Lowering Drugs

You might disagree, but hear me out on this...The drug companies know what they want you to think. They want you to think that the only reliable predictor for heart disease is an... Read More

Ambien Sleep Medication And Insomnia: What Is Insomnia And How Can Ambien Help?

What's Insomnia?Identifying insomnia is a little like the old joke about art: you know it when you're having it. For people with insomnia, though, it's no laughing matter. Having reduced or interrupted sleep... Read More

The Top Seven Myths About Arthritis

Myth #1: "Nothing can be done about arthritis..."You don't have to put up with arthritis. Now motre than ever, there are excellent medicines that can not only treat the symptoms but also, in... Read More

An Introduction to Acid Reflux Disease

Acid reflux disease, also known as Gastroesophageal Reflux Disease or GERD, afflicts millions of people. Many suffer from an occasional bout with heartburn, but acid reflux disease, as a diagnosis, should only be... Read More

Treating Lazy Eye in Older Children

Many eye doctors believed until recently that if a child's vision was impaired because of a "lazy eye," the condition could not be corrected past the age of six or seven years. However,... Read More

The Pharmaceutical Drug Cartel and the FDA

According to the Los Angeles Times, the California Association of Physicians and Surgeons, and even the Center for Diseases Control's own admission, well over 100,000 people in this country die each year from... Read More

Generic Drug: Its Pros and Cons

A generic drug can be defined as an identical, or bioequivalent to a brand name drug in its dosage form, safety, strength, route of administration, quality, performance characteristics and intended use. Although generic... Read More

Bextra Withdrawal Could Be Just the Beginning for Pfizer

The pharmaceutical industry is a tremendously profitable one, as anyone who reads the business pages of their newspaper can see. Although it can take years to develop a new drug and bring it... Read More

Phenylpropanolamine (PPH) Lawyer: Decongestant Causes Stroke

Phenylpropanolamine, or PPH, used to be an active ingredient in many over the counter nasal decongestants and weight control drug products. The FDA pulled phenylpropanolamine off the market in May of 2000 when... Read More

Finally...Affordable Prescription Medication without Insurance.

If you are like many Americans, you are without health insurance. And the ranks of the uninsured are growing. According to the National Coalition on Health Care (NCHC), the number of uninsured was... Read More

Back Pain & Muscle Pain - Effective & Natural Pain Treatment Alternatives

Pain and Stress. They seem almost to go hand in hand - not only in their negative connotation, but also in their biological causes and triggers. Back pain and muscle pain is typically... Read More

The Cox-2 Prescription Painkillers Are Back?

This past week, the FDA held a meeting in order to decide what should be done about Merck's Vioxx and Pfizer's Bextra and Celebrex. The Food and Drug Administration originally intended to ban... Read More

Ingrown Toe Nails Medical Treatment

Medical Care:Treatment options depend on the stage of ingrown toenails, medically known as onychocryptosis.Stage 1 can be managed by recommending shoes with a comfortable wide toe box or open-toed shoes. Instruct the patient's... Read More

Zoloft Side Effects: Akathisia and Violent Behavior

Zoloft is an SSRI (selective serotonin reuptake inhibitor); a prescription drug that combats depression, anxiety, posttraumatic stress disorder (PTSD), panic disorder, obsessive-compulsive disorder (OCD), as well as other various problems. SSRIs work by... Read More

Mexico: Drugs Galore!

You are going to find this incredible and I assure you I am not making any of this up: You can waltz into any pharmacy (Farmacia) in Mexico and buy almost anything without... Read More

Your Kidney Function Really Matters: A Lighter Look at What You Need to Know to Prevent Adverse Dru

When you (or loved ones) are taking prescription or over the counter medications...there is a lot you should be worried about, and a lot that your pharmacist may not be telling you.Most people... Read More

22 Inside Tips on How You Can Make Your Arthritis Medicines Work Twice as Effectively in Half the..

This report will give you 22 important tips to make sure that you're getting the very best out of your arthritis treatment program.1. Make absolutely sure that the nurse or doctor knows what... Read More

?Foot Pain Relief At Last!?

"As an arthritis specialist, one area that I see people complain about more often than almost any other, is their feet." So says Dr. Nathan Wei, Clinical Director of The Arthritis and Osteoporosis... Read More

Carpal Tunnel Syndrome - Steroid Injection for Carpal Tunnel Syndrome

What is the role of steroid injection in carpal tunnel syndrome?Injection of corticosteroid into the carpal tunnel has been used as a treatment for some years. But what does the published evidence have... Read More

Bee Propolis: Synergisitc Health Care for the 21st Centruy

For well over a century modern science has progressed at a startling rate. With this increase in knowledge has come medicinal and healthcare benefits that have seen ages peak and diseases eradicated. These... Read More

Irritable Bowel Syndrome - Cybill Shepherd Reveals All

Cybill Shepherd has revealed that she suffers from irritable bowel syndrome (IBS). The star of Moonlighting and Taxi Driver says that she has struggled with her symptoms for many years, and is now... Read More

Understanding Tumescent Liposuction

Tumescent liposuction is done using a local aesthetic. A large volume of saline solution containing the aesthetic and a drug called "Epinephrine" is injected directly into the areas where there are excessive fatty... Read More