What Are Foot Orthotics?
Foot orthotics are shoe inserts that can be custom-made to prescribed specifications or purchased "off-the-shelf." Custom-made orthotics are generally considered more effective and of higher quality than prefabricated foot orthotics.
Custom-made foot orthotics can:
- correct an abnormal walking pattern
- reduce pain
- provide support
- prevent or protect against worsening foot deformity
- provide better positioning (foot alignment)
- relieve pressure on a certain area of the foot
- improve the overall mechanics of the foot and lower extremity
How Are Custom Foot Orthotics Made?
The cause of the foot pain -- injury or a disease/condition -- is what determines the type of foot orthotic designed for a specific patient. The removable shoe inserts are made from an impression of the foot -- either a plaster cast mold or a 3-D laser scan -- and are then adjusted to fix the problem.
Who Is Helped by Wearing a Custom Foot Orthotic?
A Cochrane Review, published online July 16, 2008, evaluated the effectiveness of custom foot orthotics for various types of foot pain. In the review, 11 trials involving 1,332 study participants were analyzed:
- 5 trials evaluated custom foot orthotics for plantar fasciitis (691 participants)
- 3 trials for foot pain in rheumatoid arthritis (231 participants)
- 1 trial for foot pain in pes cavus (high arches) (154 participants)
- 1 trial for hallux valgus (bunions) (209 participants)
- 1 trial for juvenile idiopathic arthritis (47 participants)
The Cochrane Review concluded that:
- in adults with painful pes cavus for more than a month, custom foot orthotics decreased foot pain after 3 months compared to fake foot orthotics).
- in juvenile arthritis patients at least 5 years old, custom foot orthotics reduced foot pain after 3 months compared to wearing supportive shoes, but did not reduce pain after 3 months when compared with prefabricated neoprene shoe inserts.
- in adults with rheumatoid arthritis custom foot orthotics reduced rearfoot pain after 3 months compared to no treatment, but did not reduce foot pain after 3 years compared to fake orthotics. Custom orthotics did not reduce pain in the big toe joint after 6 weeks or 3 months any more than supportive shoes or non-custom foot orthotics.
- for plantar fasciitis, custom foot orthotics did not reduce pain at 3 or 12 months compared to a fake orthotic. Custom orthotics were not superior to night splints in these patients. It may also not reduce foot pain after 2 weeks any more than a combined treatment plan of manipulation, mobilization, and stretching for patients with plantar fasciitis.
- in patients with hallux valgus who were less than 60 years old, custom foot orthotics reduced foot pain after 6 months compared to no treatment, but may not be as effective as surgery after 6 or 12 months.
The improvements that occurred after using custom foot orthotics were modest -- 11, 14, or 19 points on a 100-point scale. But any relief is significant relief for people suffering with foot pain. If you have persistent foot pain, ask your doctor if foot orthotics would help you.
Prescription Foot Orthotics Can Help You Put Your Best Foot Forward. Rock Positano, DPM, MSc, MPH. Hospital for Special Surgery. 10/12/2004.
Custom-made foot orthoses for the treatment of foot pain. The Cochrane Library. Fiona Hawke et al. Published online: 16 July 2008 in Issue 3, 2008.