Orthotics: legit? or podiatrist goldmine?

I have toe problems and have been seeing a podiatrist, who did some surgery and now says I need orthotics. He says the point is to help the rest of my foot work properly so my toes do better.


But I keep getting the impression that these things are more an easy sell moneymaker for podiatrists. They take plaster molds of your feet, send them off to an epoxy casting shop, bring you back and grind at them a little to make them fit, and charge many hundreds of dollars for what is probably two hours of work and ten dollars of materials. The results are going to be hard to quantify and very subjective. It’s hard to prove there couldn’t be some kind of benefit, but the big problem is my toes are paralyzed and wind up curling under each other, getting crushed and misshapen. Thinking about the mechanics of my foot’s metatarsal and tarsal bones, it’s hard to see why orthotics are going to make any difference (and half of the orthotics are going to be on the other foot which has no problem).

So, how do we know this is really a legitimate treatment for what ails me?

BTW I am going ahead with them on his recommendation, partly because I think he may give me crap if I don’t buy them but still need more toe surgery, but am still curious!

Orthotics I’ve seen in the past have always been prescribed by orthopedists, not podiatrists, but why not podiatrists? Orthotics have replaced metal braces for children with problems with their legs (maybe arms too, but I’ve only seen legs). They are far lighter than metal braces used to be, and don’t get hot or cold on days when temperatures are extreme. They are certainly not a rip-off for children who need them, and because you can make them in any shape, orthotics can be used to correct things that used to require minor surgery, or orthopedic shoes. With orthotic inserts instead of orthopedic shoes, children are free to wear any shoes they want, instead of unattractive orthopedic shoes. I bought shoes for a client a couple of times, and they were usually one size bigger than what he needed without his orthotics on, so when he outgrew shoes, he kept them around for some occasion when he might need shoes but no orthotics.

Now, I don’t know what profit your podiatrist makes, and I don’t know enough about your particular situation to say whether you, specifically, are being ripped off, but you are not just paying for the polymer itself that the orthotics are made from: you are paying for all the knowledge of the prescriber and the builder, which is considerable in both cases. It’s like when you buy a part for your car: you are not just paying for the cost of the raw materials that made it; you are paying for all the engineering that designed it and technology that built it. Take that into consideration.

Orthotics have been a lifesaver for me. They are the only thing that has consistently allowed me to walk pain-free. They were prescribed by an orthopedist, though, not a podiatrist. And he had incentive to recommend surgery over orthotics, so why would I disbelieve him if he’d make tons more off the surgery? (He doesn’t make anything off the orthotics beyond the office visit; he refers out to an orthotist.)

I’ve been wearing them since the 1990s. They’re legit.

Mine were prescribed by a podiatrist for my plantar fasciitis, which had plagued me for years. I tried everything, including that Good Feet scam operation, and nothing made it more than temporarily better. Keen shoes worked well for awhile, but it eventually returned, making lengthy walks or hiking impossible. The orthotics were uncomfortable at first, but eventually my feet adjusted and I’ve been pain-free for nearly five years now. Yeah, I’m a believer.

When I had plantar fasciitis, my GP sent me to a podiatrist to get orthotics. A couple years ago, he suggested that it might be worth getting new ones, if my feet had changed. I made an appointment with a different podiatrist. She spent 15 or 20 minutes looking at my feet and my orthotics and said they looked fine to her and I didn’t need new ones. No charge! I was surprised and said so. She said that they were in the business of making customers happy. I thanked her and left.

I had a similar experience with an optometrist. The main difference is that he gets something for the examination from medicare, since I am of an age to have a glaucoma exam every year.

Absolutely legit in my personal experience. I have “flexible flat feet” - that is, I have a normal arch as long as I’m not weight bearing, but the arch doesn’t actually support me. Both my big toes start to hurt if I walk distances without my Orthotic inserts.

If you do get them, make sure you get the cast-while-not-weight-bearing type. I switched podiatrists at one point because of issues I had with some office staff. The new podiatrist was “high tech” and used some mat that I walked across to do the inserts. They didn’t really help, and I ended up going back to the original podiatrist.

Same experience for me. He asked me if my feet were hurting again. When I said ‘no’, he said the orthotics looked to be in good shape and should last at least five years unless I start having pain again.

Wow! Seems like nobody shares any cynicism on this one, so I will go into the deal encouraged and perhaps chastened.

Thanks everybody!

I was like you a cynic…but my then girlfriend, now wife, suggested it. Now going on 10 years and LOVE them. I used to wear my shoes out on the back heel edge at an angle and haven’t done that in 10 years. No foot problems at all. I have the original orthotics but have had them recovered twice.

In my opinion one of the best investments I have made for myself.

Good luck!

This is a very timely discussion. I have sesamoiditis, which is the inflammation of the two small bones at the bottom of the foot. This is a very painful condition–walking more than a block or two often becomes unbearable. Using a metatarsal pad this weekend in DC I walked over five miles with very little pain. I’m using “movable” Dr. Scholl’s off the shelf, but these can be built into an orthotic and are an absolute foot saver.

IANAD, but my wife is a Physical Therapist. Orthotics, in general, are a legitimate option for some foot/leg issues. Like any other therapy, they can be over priced and over prescribed. Whether they will help in your specific case can’t be determined here, obviously. If you are uncomfortable with the diagnosis or suggested course of treatment, a second opinion is highly recommended!

I’ve had some for the last few years but am considering not having them replaced when they wear out. My issue is seriously huge callouses that form on the bottom of one foot. I don’t know why they’re forming, and no doctor has cared to offer up an opinion on that. The biggest one is on the bottom of my heel. Stand barefoot on the floor, and notice where your heel connects with the ground. That spot is where my callous is. The orthotic was supposed to help take pressure off it, but how can you walk without putting pressure on the bottom of your heel? Needless to say, after using the orthotics for several years, that callous is still huge and not going away.