Orthoses
(frequently called 'orthotics') are special shoe inserts which provide control of the mechanical functions of the foot and leg, or accommodate for bony prominences on the bottom of the foot. Often, a pair of orthoses
will be prescribed so that they will do both. Orthoses are custom made from plaster cast impressions taken from the feet. Once measurements of bone, joint and muscle function have been made, and a detailed examination
of how your foot functions while you walk, a prescription is written for each foot. This instructs the orthotic lab how to fabricate the orthoses so as to provide you with the desired correction to your foot function.
In general, orthotic devices, such as foot orthoses or glasses prescribed for visual problems, correct the functioning of the body part without correcting the underlying structural abnormality.
Orthoses are frequently
used in conjunction with other conservative (non-surgical) treatments, such as corticosteroid injections, self-administered home physical therapy, short-term analgesics of the aspirin class, and changes in shoewear.
The principle alternative to these treatments is frequently surgical.
Treatment
Orthoses are used to alleviate pain and to establish or restore normal foot function. The occurrence of pain in the
feet can be due to numerous causes which can be treated with orthoses. Flat-footedness is a commonly occurring problem. It can cause increased traction on a band on the bottom of the foot, called the plantar fascia.
This can result in tearing of that band, and disabling pain. An orthosis can restrict the motions through the foot, diminishing the traction on the plantar fascia. In most cases, the orthoses, along with other
conservative treatments, will alleviate your pain. Similarly, problems such as bunions, pinched nerves, over-stressed tendons (resulting in tendinitis), bursitis, ankle instability (resulting from repeated ankle
sprains), deformities from inflammatory arthritis, can be treated effectively with orthoses.
Foot pain can result from the incorrect motion of bones and joints. These motions can cause some parts of the foot to
support more body weight than is normal. Some muscles may be forced to pull abnormally hard. Ligaments, tendons and other soft tissues become torn. Over time, this strain becomes a chronic injury, and results in pain
and deformity.
A specific type of orthosis, called a functional foot orthosis
is used to control the abnormal foot motion. This devices are rigid. Weight is carried more evenly on the foot. Soft tissues are relieved of strain. While orthoses will not reverse bone or joint changes, soft tissue healing can take place and pain is usually reduced or eliminated. Retrograde strain at the knees or hips may also be relieved.
Accommodative foot orthoses are used with foot problems where the goal of treatment is to redistribute body weight without affecting the mechanical function of bones, joints and muscles.
These devices are more soft and cushioning, and may be used to relieve stress at a bony prominence or open sore (ulcer) on the bottom of the foot. Examples of such use are diabetic or arthritic feet which have joint breakdown.
Benefits of orthotic treatment