Prescription Orthoses

For serious foot problems or when over the counter devices fail to provide relief, prescription orthoses may be necessary. Talk to your doctor about the possibilities.

Prescription Orthotic Devices

Such devices are prescribed by a doctor following a complete evaluation. This careful evaluation determines whether the orthotic device is the most appropriate treatment. There are several steps involved in obtaining these devices.

Initially, a history is obtained from the patient. This may include reviews of the chief complaint, how the injury occurred, any other injuries, self-treatment, shoes, level of activity, and any other information that may relate to the problem.

An examination of the lower extremity is then done. This determines any biomechancal problems that may be present.

The alignment of the joints and the amount of motion within the joints is determined. X-rays may also be obtained to more accurately assess the relationships of the bones and joints. An evaluation of the extremity in motion may also be done at this time. After it is confirmed that an orthotic device is the best treatment, casts of the feet are the next step.

This must be done carefully, in order to capture the contours of the feet and to maintain the neutral positions of the feet. The casts are then sent to a laboratory, where models of the feet are constructed.

The orthotic devices, including any corrections or modifications that may have been requested by the doctor, are fabricated on these models. After the orthosis is dispensed to the patient, a gradual break-in period is needed. During this time, additional minor corrections may be done on the orthotic device to fine-tune it for the patient.

It should be remembered that an orthosis is not the final answer for treatment or prevention of injuries. It may only be part of an overall treatment plan, which may include such other modalities as medication, physical therapy, surgery, rehabilitation, and training modification.

The main disadvantages of prescription orthotic devices are their high cost (300 to 400 dollars) and the fact that they may not always work. Yet, if the evaluation is done properly and the orthotic devices are used as indicated, there is a very high success rate.

The injured athlete faces a dilemma in trying to choose which type of orthotic device is most helpful. If the injury is minor, and the athlete has a sense of where the problem may be, trying a simple device may be enough to resolve the problem. However, if the injury becomes more severe or recurs, professional help should be obtained.

A doctor should also provide more information about the injury and should offer alternatives and sugestions about simpler types of devices.