Orthotics

What are orthotics?

Orthotics, also called orthoses, are devices that are worn to correct foot and ankle problems without surgery. Most people think of shoe inserts or “arch supports” when they hear the word orthotics, but they can include devices such as foot pads, shoe inserts, ankle braces and similar items. Treatment can often begin with less expensive off-the-shelf orthotics and progress to a custom orthotic if the diagnosis and symptoms require it.
 
Foot pads are the simplest devices. They can be placed on the bottom of the foot, or inside the shoe, but take up only a small area in the shoe. They are used to treat conditions that often cause pain at the front of the foot. Many styles, shapes and sizes can be found. Common examples include circle or “doughnut” pads to cushion a callus or corn.
 
Shoe inserts, also called inlays, insoles, foot beds and arch supports, are placed into the shoe. These are used to treat


A custom full-length semi-rigid orthotic insert with multiple layers of material for cushioning and support

 a wide variety of problems, including foot arthritis and flat feet. There are many different kinds of inserts, from ones that are soft to ones that are very firm. Some come ready off the shelf in different sizes or shapes. Others need to be shaped to an individual’s foot. The purpose of these inserts is to create a solid foundation for the body.
 
Custom foot inserts are custom-molded to the foot. They may support, correct or prevent foot abnormalities or deformities. Varied practitioners, including prosthetists, orthotists and certified pedorthists, can make custom orthoses.
 
A period of adjustment is required for any new shoe inserts. The shoe inserts and the shoes are considered as a unit because the inserts occupy volume inside the shoe. This leaves less room for the foot.  An appropriate period of “breaking in” should be allowed for a new insert. If it causes pain or pressure to the foot, the practitioner can make adjustments to improve the fit. Adjustment and proper fitting of the orthosis is typically included in the service provided.
 
Ankle braces are devices that the patient must put on before fitting into a shoe. They are used to treat a large variety of diseases like ankle arthritis, foot drop and tendinitis. Depending on the type, severity, and location of the condition, some braces need to be custom made for the patient.
 
Shoes are important. They can improve the success of foot and ankle orthoses. The practitioner making the orthosis will ask that the shoes be brought to the office for planning and fitting. Not all shoe types will work properly with orthoses. This should be discussed with the practitioner before purchasing shoes.
 

Do orthotics work?

It depends on the problem. Orthotics can be of benefit in changing the pressure on certain parts of the foot and thus relieving symptoms. This is especially true in diabetics and other individuals who are at risk for skin breakdown. Certain ankle braces are good at controlling motion and can help to unload an arthritic joint. The result can be pain relief for patients who are unable or unwilling to undergo surgical correction.
 

How much do they cost?

In October 2013, a Google search reported more than 1 million orthotics options ranging from $10 to $800. Off-the-shelf devices range from basic inlays purchased at the drug store for $10 to $20 to more advanced orthoses sold for $150 to $200. Semi-custom orthoses (off-the-shelf versions that can be modified) range from $60 to $300. Custom orthotics can cost anywhere from $300 to $800.
 

Will my insurance cover my orthoses?

Most current insurance programs do not pay for orthoses, even if prescribed by your doctor. If they are not covered under your health care plan, they may be a covered medical expense under a Flexible Spending Account. Medicare Part B currently covers one pair of shoes and three pairs of shoe inserts per year for patients who have an approved diagnosis of diabetes and related conditions.
 
The American Orthopaedic Foot & Ankle Society (AOFAS) offers information on this site as an educational service. The content of FootCareMD, including text, images and graphics, is for informational purposes only. The content is not intended to substitute for professional medical advice, diagnoses or treatments. If you need medical advice, use the "Find an Orthopaedic Foot & Ankle Surgeon" tool at the top of this page or contact your primary doctor.