How does an orthotic relieve foot pain?
An orthotic is a device that fits into your shoes whose purpose is to re-balance and reposition your feet relative to the ground.
Most people think of orthotics as nothing more than arch supports used in treating flat feet and while an orthotic will support the arch and is used in flat feet, the uselfulness of an orthotic goes way beyond that.
The purpose of this site is to explain how an orthotic can be used for a wide variety of foot pain along with ankle, leg, knee, hip and back pain as well. In many instances an orthotic can be a simple way to remedy any number of lower extremity problems eliminating the need for more aggressive therapies including surgery. Simply put, orthotics are just one way to treat many foot and leg problems; it is beyond the scope of this site to detail other treatment methods for the various medical conditions that will be discussed. For a more in depth discussion of medical issues of the foot, ankle and leg, please visit my site Foot-Pain-Explained.
When discussing orthotics with my patients I use the analogy of orthotics to prescription eyeglasses. Eye glasses will correct an eyesight deficiency for as long as the glasses are being worn. Remove your glasses and what happens? Your eyesight reverts back to its deficient state. Orthotics are the same way. When wearing an orthotic, the device repositions your feet and this change in gait will eliminate the medical problem at hand, but in most instances, if you stop wearing orthotics your particular pain may very well return.
We see this mainly in people who have a biomechanical deficiency in their gait. In other words there is an imbalance in the way they walk which has lead to pain. An orthotic corrects that deficiency and thus pain is reduced.
Orthotics come in many varieties and are sometimes referred to as insoles or shoe inserts. There is certainly no shortage of arch supports sold in supermarkets and drug stores and for simple problems like "tired feet" a store bought arch support may be fine. In fact, most people who present to my office complaining of foot and leg pain have already tried some device they purchased in the drug store. However, as you read through these pages you will begin to understand why many medical problems cannot be solved with a store bought device and a custom device is usually necessary.
In between a store bought arch support and prescription orthotics is what is known as an off the shelf medical grade orthotic. Most of the orthotic labs starting offering these devices for those individuals who needed more than an arch support, but perhaps the cost of a prescription orthotic was prohibitive. These devices are made out of prescription grade materials and can somewhat be adjusted to arch height as well as the ability to have limited additions added to them. They certainly have a place in the orthotic discussion and for a lot of foot and leg problems can be very effective. On this site I offer off the shelf medical orthotics that I have found to be way above average and very helpful in many conditions. Where appropriate, I will mention them as an alternative, when discussing various foot and leg problems on this site.
This site deals mainly with prescription orthotics which are custom made devices in the same manner as prescription eyeglasses; they will work for the person they were made for and in most cases be useless for anyone else, even if that person is the same shoe size. When you have a prescription orthotic made, in most situations, there will be things built into the orthotic that attempt to re-balance or change the position of the foot other than just trying to support the arch.
In order to make a prescription orthotic, the shape of the foot has to somehow be "captured". As previously stated, an orthotic basically brings the ground up to the foot, so the foot does not have to abnormally position itself in order for a person to propel forward. We try and capture the foot (feet) in what is known as its neutral position, or the ideal position of the foot relative to the leg.
Probably the most common technique used to make a prescription orthotic is through the use of plaster of paris molds of the feet. The plaster is applied and then the foot is held in its neutral position relative to the leg. Although this is a messy endeavor, most experts consider it to also be the most accurate means to capture foot structure.
Two other techniques include stepping into a box with foam in it that captures the footprint the same way as walking in the sand does on the beach. The foot needs to be held, once again, in its neutral position as it is being placed in the foam box and this leaves a lot of margin for error.
The other technique is scanning of the feet which then sends an image to a computer and from there the orthotic labs can fabricate the device.
As I go through the various medical conditions that may respond to an orthotic, whenever possible, I will mention whether or not anything less than a prescription orthotic may be tried. Store bought devices are small monetary investments so if they help, great, if not, the loss is minimal.
Besides foot structure and the particular problem that is being addressed, there are other issues that must be taken into consideration when dealing with orthotics. Some of these issues include body weight; obviously someone weighing 250 lbs. will require an orthotic different from an individual weighing 125 lbs. In addition occupation comes into play. A person who makes their living standing or walking all day will have different needs than the person who is seated most of the day.
Lastly, the type of shoes a person wears will also have a bearing on the type of orthotic that is required. For a women who has an occupation that requires wearing very fashionable shoes there will be limitations with the type of orhotic that can be made because generally speaking, the more fashionable the shoe, the less room there is for an orthotic.
I have broken this site down into anatomical areas of the foot and leg. If you know your condition use the navigation bar above to find it and an explanation of the types of orthotics that may be required along with any modifications needed in order to treat the condition.