More than just a heel pad or shoe insert, orthotics can be used as part of a comprehensive treatment plan. They are a customized shoe or heel insert made for your specific feet. Orthotics can help with correcting foot deformities, helping the foot or ankle to function better, provide support to the ankle, and help reduce the risks for further injuries.
When you decide to purchase orthotics, the process begins with a physical exam of your feet, looking for deformities and areas of excessive pain. You will likely be asked to perform activities to determine how the feet and ankles are positioned during certain exercises. Special imaging pads can be used to help determine if there are any problems in the structure and function of your feet. X-ray, bone scan, and MRI can be recommended to help identify areas of arthritis, damage, or injury. All of these diagnostic methods are then used to recommend treatments, including prescribing orthotics.
Examples of medical conditions that orthotics can treat include:
- Arthritis. Rheumatoid arthritis and osteoarthritis can cause discomfort in the feet and poor positioning that orthotics may help to correct.
- Back pain. Sometimes poor positioning of the feet, such as arches that roll inward, or lack of cushioning can cause pain that orthotics can lessen.
- Bunions. Bunions are painful bumps that can develop at the base of the big toe and cause foot deformities. Orthotics with a wide toe box can help to reduce pressure on the big toe.
- Bursitis. Inflammation of fluid-filled sacs in the heels and toes can cause bursitis pain and discomfort. Orthotics with heel and arch support can help to reduce bursitis discomfort.
- Diabetes. Sometimes, a person with diabetes can lose sensation in their feet, a condition known as diabetic neuropathy. When this occurs, orthotics can help to reduce excess stress and pressure that can lead to foot ulcers.
- Flat feet. Flat feet can cause foot, ankle, and back pain. Orthotics can help to support the feet and promote proper foot positioning.
- Hammer toes. Hammer toes often occur as a side effect of bunions on the big toe. They cause second-toe pain and deformities on the ball of the foot. Orthotics can provide additional support to the feet and reduce the likelihood that hammer toes will worsen.
- Heel spurs. Heel spurs are conditions where excess bone grows on the back or bottom of the heel. Orthotics can support the foot and reduce inflammation.
- High arches. Very high arches can stress muscles in the feet and lead to a number of conditions, such as shin splints, knee pain, and plantar fasciitis. Orthotics can help prevent a person’s feet from rolling excessively inward or outward.
- Injuries. People who’ve experienced trauma to their feet and ankles may require extra support during the healing process with orthotics.
- Plantar fasciitis. Plantar fasciitis is a common cause of heel pain. Doctors may sometimes recommend orthotics to support the heel and foot.
Orthotics can also be prescribed for those who have positional concerns with their feet or legs, as well as those with underdeveloped leg and foot muscles.
Orthotics are many times used along with other treatments such as supportive shoes and physical therapy exercises. Nonsteroidal anti-inflammatory drugs (NSAIDs) may be recommended to help reduce pain and inflammation. Along with other treatments, orthotics can be used to help avoid more invasive treatments, such as surgery.
There are many materials used to make orthotics, and the chosen material will be dependent on what condition and symptoms a person has. They can be very rigid (carbon fiber or plastic), or flexible and cushioning, full-shoe inserts or smaller heel inserts. They can be used in conjunction with braces, other shoe inserts, or taping (kinesiology taping).
Although orthotics will not help all people, how effective they are can depend on the training and experience of the person making the orthotic, the doctor’s prescription, the shoe they are used in, and how often the person wears them.
QUESTIONS TO ASK WHEN YOU CALL YOUR INSURANCE COMPANY
- Do I have custom-made orthotic coverage on my plan?
- How many pairs am I covered for each cycle?
- What percentage is covered (100% or partial)?
- What is the maximum payable (dollar amount) per pair? Per year?
- Is orthotic coverage based on a calendar year, or other benefit year? (Or 12 rolling months, 24 rolling months, etc.)?
- Do I require a prescription?
- If so, can a chiropractor write the prescription?
- If not, who can write the prescription (e.g., medical doctor)?
- Who can dispense the orthotics? (Chiropodist, Podiatrist, Chiropractor, Physiotherapist, Manual Osteopath?)
- Is assignment of benefits allowed? (e.g., will they pay the clinic directly?)
- Is there a deductible?