How much do orthotics cost?

In My Humble Opinion
1

Last year I found out I had a neuroma in my right foot and got a cortisone injection that killed the pain for awhile. The pain had long since returned, and I finally got enough money to go to a podiatrist here in Queens and get another cortisone shot. He wanted to do an x-ray to make sure nothing else was wrong with my feet, to which I agreed. Today, we got the results back and he told me that I have the beginnings of hammertoes.

According to the doc, my condition is far from severe, but will worsen over time without surgery. He thinks that, with care, I’ll be fine for several years before I need surgery. Since I don’t have health insurance, he suggested that I try orthotics for now until I somehow come into enough money for surgery. His estimated price for a custom orthotic is about $400, which is a hell of a lot for me (I’m a waitress). I already paid him $200 for two visits, one cortistone shot, and the x-rays, plus I just went to the endocrinologist (good news there: no hyperthyroidism) and paid $600 for a crown for a tooth. The thought of having crippled feet on top of a neuroma is overwhelming.

My questions: is $400 a normal amount for custom orthotics? Should I try over-the-counter orthotics first and then graduate to custom if needed? Is surgery really inevitable or is there any hope that orthotics will fix the problem? My friend told me to get a second opinion, but goddamn, I can’t afford to go to extra podiatry appointments.

2

Re “hammertoes” it often seems to be less of question of orthotics and more of simply getting a pair of shoes that fit comfortably and correctly with plenty of room in the toe box area. Women are often in pursuit of “small” and “cute” at the expense of their feet.

I’d suggest trying a pair of Keen’sto see if you can get relief. You might try half a size larger than normal as well.

If you want you can also try getting a pair of orthopedic shoes on ebay for maximum toe room.

3

Do yourself a favor and buy a pair of Dansko Professional Clogs and make sure they aren’t too tight (they’re supposed to fit loose). They are a helluva lot cheaper than a custom orthotic and will give your forefoot the room it needs while also providing excellent arch support. Don’t continue wearing the same shoes that have gotten you into this situation in the first place. (Assuming your issues aren’t purely genetic.)

I’ve worked on my feet for most of my adult life and those clogs, while not the most attractive thing to wear, made a huge difference in eliminating severe lumbar and foot pain years ago. Also, spend as much time as you can stretching and exercising your feet to strengthen them and counteract the misshaping that footwear can cause. With stronger musculature and more limber tendons, you may eventually find you need to rely less on external support.

I second the recommendation to look into Keens as well. They are much wider in the toe box than most shoes and are shaped more the way our feet are supposed to be shaped.

Please, do make sure you’re wearing the correct size. Not saying you aren’t, but it’s a common enough problem to mention. I’d estimate that 90% of the people I see that have foot problems come in wearing their shoes too small and are shocked/appalled that I’m recommending a half to full size larger. Shoe sizes are no more static than pant sizes; the fit changes from brand to brand, design to design, but also your 40-year-old feet and not the same as your 18-year-old feet.

Disclaimer: I work for REI and, of course, my post here is my own personal opinion and does not represent REI in any way.

4

I second the Dansko clogs. I have bone spurs in my feet and they’re the only shoes I can wear without pain. And the toe box is big so it shouldn’t squish your toes. They come in all kinds of fun colors and patterns and I always get compliments on mine.

As for the orthotics, I paid $450 for mine several years ago. They really helped with the pain and I don’t have to wear them all the time now. But my insurance covered a good portion of it.

5

Yup, $400 is what mine cost (though insurance paid 80%). I don’t wear them, though, because my problem went away when I threw out my Crocs.

And I also love Dansko/Sanita clogs.

6

I think I paid $350 for my last pair of custom orthotics, so $400 doesn’t sound out of whack. You could always try buying one of the Dansko shoe styles that has a thick removable insole; they are damn fine shoes in any case, but then if you need the orthotics anyway, you can probably wear them with the Danskos, which hold up forever. (Check danskooutlet.com, Zappos.com, etc. once you know what size you need.)

Custom orthotics still beat the hell out of daily anti-inflammatories, cortisone injections, etc. - less invasive, and cheaper in the long run. I’ve had my current pair for going on 3 years. (And a neuroma is one of my issues, too - it hasn’t bothered me since they added the neuroma pad to my last pair of orthotics.)

7

A nitpick: my doctor gently pointed out to me that the correct term is “orthoses”, not orthotics. Orthotics is the medical field, orthoses are what they make.

8

Your doctor might want to have a word with the American Podiatric Medical Association, in that case.

9

May I put a word in for a therapy other than orthotics? I’m not a doctor or therapist of any kind, but I have had spine surgery, thankfully only one time.

When I was on the path to a second surgery (disc problems again), I found a treatment called Rolfing Structural Integration. I hesitate to even recommend it here since I don’t want to proselytize. But it was a very effective treatment for me. Not cheap, but way less costly (on many levels) than surgery!

I know rolfers do work with the feet. My rolfer worked on mine, and I remember that she mentioned how unhealthy she thought orthotics were, generally. I’m not saying your orthotics would be unhealthy, Mississippienne, just that you may find great relief from rolfing.

Best of luck and I hope you feel better soon, whatever path you take!

10

Or tho sis. Or thot ics. Among hundreds of others. All that aside, the terms are generally used interchangeably, if incorrectly.

11

OK, but ‘orthotics’ is used not just by podiatrists, but by just about everyone else as well, so it’s pretty much understood what people are talking about when they refer to orthotic devices by the shorthand, orthotics. Just like prostheses are often referred to as prosthetics.

12

Mine have always been free since my uncle is a podiatrist :smiley: However, I’ve always heard in the $500 range.

13

Yes, that’s why I called it a nitpick and said that the terms are used interchangeably. Or did you miss that part? Hell, I also call them orthotics.

14

Fine. I’ll be nice then and I won’t call you a grammar nazi. :wink:

15

Does that mean I have to remove my shoulder patch? To further confuse things, “prosthetic” is also apparently somewhat incorrect. It’s either a “prosthetic device” or a “prosthesis”. The people who make these things are orthoticists or prostheticists, according to national organization sites.

16

I recommend “try any other treatments first”. I had a host of problems (ankle rolling, shin splints, etc) while a runner in high school. I got custom orthotics, something like $200, $250 maybe. They were horridly uncomfortable. They sit in a closet now. Lots of people’s custom orthotics sit in a closet, and they’re not exactly returnable.

Meanwhile, I love Spenco Polysorb insoles (though they could have better arch supports. Also may try Superfeet’s berry insoles; both have excellent reviews on Amazon. Superfeet are like custom; you heat them in the oven and stand in them for a bit to mold them.

I may start a thread on the best insoles for work shoes, since mine don’t have removable inserts so they’d have to be super-thin.

17

If you are referring to these Spenco Polysorbs, they are a completely different type than the Berry Superfeet. These Spencos are soft orthotics, which are not designed really for arch support but more for shock absorption and relieving pressure in sore areas (i.e., soreness from bone spurs and lack of adequate fat pads). They are made of foam only, which is completely flexible and does not support weight, so they will not stop the arch from overpronating or collapsing.

The Superfeet are a rigid orthotic with a bit of dense foam on top and a rigid plastic form on the bottom that runs from heel to midfoot which supports the arch, preventing collapse or overpronation, and the heel, reducing the spreading out of the fat pad from under the heel bone to alleviate pain from lack of natural cushioning.

You really can’t compare these two orthotics. They aren’t designed to perform the same tasks.

This is actually incorrect. Although Superfeet does sell custom orthotics, the one you are referring to, as well as the Green, Blue, Orange, and Black, are not heat moldable. They are, however, trim-to-fit (length-/width-wise). You trim them, stick them in your shoes and go.

If you prefer a heat moldable orthotic that does provide arch support, but allows for natural pronation and movement in the foot, take a look at the Sole semi-rigid orthotics. They also get good reviews.

I’ve worn the Berry Superfeet and the Dean Karnazes Soles and I prefer the flexibility of the Soles, but with a medium arch, I found I needed “break-in” time to get used to the feel of them in the arch area. They are a bit more aggressive than the Superfeet and I find that it’s rare for a flat-footed person to find them comfortable, honestly.

Try the Black Superfeet. They are for low volume shoes, like casual or slip-ons, or for shoes in which you can’t remove the sockliners. They take up less space in the shoe leaving more room for your foot. The Black arch support is lower, however, than that of the Berry as it’s designed for flat to low arches, whereas Berry is more for medium to high and also has extra foam in the forefoot for shock absorption.

18

I ordered a Blue Superfeet last night, let’s see how it goes. I was thinking of buying one of those gel toe-spacer things that you slip on over your toes while walking around your place barefoot – would that help my hammertoes?

I have another appointment with the podiatrist next Friday. I think I’m going to tell him to hold off on the custom orthotics for awhile. I might get another cortisone shot (the neuroma pain really isn’t subsiding) or graduate up to an alcohol shot.

I’m really sad about this. I was never a heel-wearer, and I always felt like I bought fairly sensible shoes. I think I just have crappy feet.

If I do end up needing surgery to remove the neuroma, I’d like to save up and do it all at one time – the neuroma, the ganglion, and the hammertoes. I wonder if this is do-able. I’ll ask my podiatrist when I see him.

19

I really know very little about orthotics, but I just wanted to mention that as I walked through WalMart last night they had a new display up…a scanner-type machine that you stand on in shoe-less feet (“Cleaned regularly with Anti-bacterial products!”) and it tells you what type of orthotics to buy from their display. I didn’t check prices or try it. no idea even what company it was, though I think it might be Dr. Scholls.

20

Whoops, my mistake. I thought Amazon reviewers were saying to stick 'em in the oven, so I was going based on that.

Keep it mind it’s not always about genetics but also about weight. If you’re putting extra weight on those feet for years and years it doesn’t matter what kind of sensible shoes you wear.

Let us know how the blue superfeet work! The arches of my polysorbs just aren’t high enough, so I was thinking of graduating to the blue or berry superfeet.