Upon entering a general shoe store, running specialized shoe store, or in the pharmacy department there is always a display of many types of orthotics. Who needs orthotics? What is the difference between the different types of orthotics? Also, why would anyone get the podiatrist’s custom-made orthotics when orthotics in the store are less expensive?

There are multiple reasons that a patient may need orthotics. Some of the reasons are, for a patient who wants more padding in their shoes or a patient who may have a recurrent callus from too much pressure in one area. However, most patients are recommended to get custom-made orthotics, so that their foot will function “properly.” If the foot does not function “properly,” that means that too much stress is being placed on the foot during the day, which ultimately will lead to generalized foot, knee, hip, and lower back pain.

There are 3 classifications of foot orthotics, which are: over-the-counter orthotics, customized orthotics or custom-made orthotics. All 3 may appear the same, but there are some major differences.


  1. The over-the-counter foot orthotics are bought from the store in a package marked with standardized shoe sizes. There is nothing about this orthotic that will cater to your specific needs. An over-the-counter foot orthotic may be a beneficial addition to shoes for a patient who would like more padding.

 2. The customized foot orthotics are made for you by stepping into a foam box or stepping on a pressure mat. Since these orthotics are made to seem as though they will fit your needs, this method still may not be beneficial even though your specific foot measurements are taken. The foam box and pressure mat will capture where the most force is on your feet, and then the orthotic will be made so that the areas of high pressure are transferred more evenly throughout the foot. This is called an accommodative orthotic, which will not change the way the foot functions, but will provide relief to the patient with a recurrent callus. These orthotics are made specifically to decrease the pressure in the problematic areas.


  1. A podiatrist makes the custom-made foot orthotics. The goal of these orthotics is to change the way that the foot functions. Foot, knee, hip, and lower back pain can be lessened or totally gotten rid of if the foot is functioning in proper alignment. The orthotics the podiatrist makes are the most specialized, because the podiatrist will put the foot into the neutral position. The neutral position is the position that the foot will function to be the most efficient, without causing strain to the foot joints and muscles, which will decrease the pain in the foot, knee, hip, and lower back. The podiatrist will then make a cast, with a plaster-type of material, to capture the foot in the neutral position. The making of the cast will take about 15 minutes and it is removed after the plaster has hardened.

 There are many other reasons that patients may need any one of these types of orthotics besides the examples given. A podiatrist will be able to help you select the “right” type for your needs.

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