Need Orthotics? Try OTC Versions First

by Berkeley Wellness  

Orthoses, popularly called orthotics, are foot supports made of various materials (foam, leather, plastic, fiberglass, graphite) that fit inside shoes. Some are flat, some molded; some have gel fillings. By cushioning and helping support the foot, they can help reduce problems associated with bunions, plantar fasciitis, and some other foot conditions. They can also make foot motion more efficient and correct structural imbalances that cause pain in the knees and hips, and they are good shock absorbers when you exercise.

If you have chronic foot (or other lower-body musculoskeletal) pain, a podiatrist or orthopedist may prescribe custom orthotics, which involves making casts or perhaps digital scans of your feet—for about $400 to $600. Some medical insurance plans pay for them. But you may instead decide to try over-the-counter (OTC) insoles, which typically cost $20 or less.

Studies show that the nonprescription variety can be as helpful (or nearly as helpful) as custom ones for certain conditions. For instance, in a 2014 study in Musculoskeletal Care, people with plantar heel pain who wore prefabricated orthotics for eight weeks had the same reductions in pain and disability as their counterparts who wore custom orthotics—at considerably lower cost. Another study, in Prosthetics and Orthotics International in 2015, concluded that using any of the three OTC insoles tested “would be beneficial for the treatment, or prevention, of musculoskeletal injuries such as plantar fasciitis.” The American Orthopaedic Foot & Ankle Society endorses OTC inserts for heel pain.

Choosing an OTC insole

If you’re in overall good health, there’s no harm in trying OTC insoles. But if you have a serious foot, knee, hip, or back problem or are not in good health (for example, you have diabetes), see your doctor first: The wrong insole can make matters worse or cause injury if a serious condition goes untreated.

  • Look for a product with the APMA (American Podiatric Medical Association) Seal of Acceptance. The APMA evaluates foot products on the basis of research submitted by manufacturers to establish usefulness and safety.
  • Put insoles in both shoes. Exception: If one leg is significantly shorter than the other, you may need an insert for just that one foot.
  • Be sure the insoles fit your shoes—you usually have to buy first and try the product at home. They should not buckle or wrinkle under your foot. Many can be trimmed for fit. If you are buying new shoes, take the insoles with you to try at the shoe store.
  • If your foot tends to roll inward too much (overpronates) or you have painful flat feet, try an arch support or a full-length insert. If you have pain under the ball of your foot, wear wide shoes and try an insole that provides cushioning for the forefoot bones. For heel pain, try a heel insert made of silicone, rubber, felt, or wool.
  • You may have to experiment to find the kind of cushioning and support you need. It may take several weeks to tell if the insoles are helping. But if you see no improvement, get an evaluation from a podiatrist or other health care provider.

Also see How to Buy Shoes That Fit