Orthotics and Your Feet
Orthotics are devices which fit into the shoe to aid the foot. "Functional orthotics" are rigid and designed to control motion and correct the function of the foot. Individuals with flatfeet, tendonitis, plantar fasciitis, certain foot deformities, knee, hip and back problems may benefit from functional orthotics. "Accommodative orthotics" are soft and designed to reduce pressure and prevent excess friction. Diabetics and those with a loss of sensation or circulation in their feet will benefit from accommodative orthotics. Both types of orthotics are custom made by taking a mold of the foot.
The goal of the functional orthotic is to improve the mechanics of the foot, control the abnormal motion in the foot, decrease the pain in the foot, ankle, knee, hip or back and to add support. The orthotic should make standing, walking, jogging or running more comfortable. The orthotic must be rigid to help control the motion in the foot and add support. If the orthotic is soft, the weight of the body would collapse the device and it would no longer function.
Abnormal motion is typically in the form of pronation. Pronation is the rolling in of the foot and collapse of the arch. The motion starts at the rearfoot, or heel area. When the heel turns in, it allows the arch to collapse. This puts undue stress on the ligaments and tendons in the arch area and contributes to the development of tendonitis, plantar fasciitis, bunions and hammertoes. The functional orthotic helps to control the abnormal motion in the rearfoot. This is accomplished by taking a mold of the foot in its neutral position. The neutral position is the position the foot should be in when walking. When standing, the over-pronated foot is in the uncorrected position. The mold of the foot should be taken with the patient sitting so the foot can be placed in the neutral position.
The molds are sent to a lab and scanned into a computer. A reverse image is produced and the computer generates an image of the foot in neutral position. The computer adjusts the image based on the corrections recommended by your podiatrist. A model of the foot is then cut out, in some cases out of wood. The orthotic material is pressed over the foot model and the orthotic is created. The most common material is polypropylene, but other materials, such as graphite are used. In some cases, hand-made molds are created out of plaster. This was the classic way orthotics were made until newer technology made the process much less labor intensive.
Functional orthotics are a successful treatment for many problems affecting the lower extremity. In a recent article in the Journal of the American Podiatric Medical Association, 75% of patients surveyed had good to excellent results from functional orthotics. This includes 17% who felt the orthotics "cured" their pain. Less than 10% had no relief. The most commonly treated condition in the study was a painful heel. Over 20% of patients surveyed were treated for a painful heel and 20% were treated for a painful arch. Fourteen percent of the individuals were using orthotics for flatfeet. Other conditions treated with orthotics were knee, hip and back pain, foot arthritis, bunions and high arches. Tendonitis was not specifically evaluated.
Individuals with plantar fasciitis (heel and arch pain) who also have flatfeet usually respond best to orthotics. The plantar fascia is a ligament type structure on the bottom of the foot which helps to hold up the arch. When the foot collapses, the weight of the body stresses the ligament and results in tearing and inflammation. This results in plantar fasciitis. These individuals typically respond well to orthotics in combination with other treatments. Certain types of tendonitis respond well to orthotics and other types require orthotics. Posterior tibial tendonitis is the tearing and inflammation of the tendon that helps to hold up the arch. When this tendon is overstressed by arch collapse it cannot heal. Orthotics are essential in the treatment of this condition.
Individuals with high arches may require orthotics as well, but they do not respond as well. Orthotics can help slow the progression of bunions and hammertoes, but they will not prevent this process. Orthotics may help with some pain at a bunion, but they will not "cure" the bunion. When the motion in the foot is contributing to the problem, orthotics are generally recommended. If the foot is stable and does not require support, the bunion, hammertoe, neuroma, tendonitis or even plantar fasciitis may not require custom made orthotics for treatment. These individuals may do well with a pre-fabricated orthotic.
Diabetics can develop numbness and loss of circulation in the feet. This numbness and circulation loss puts them at risk for developing open sores on the feet called ulcerations. To help prevent excess rub and friction in certain areas on the feet, accommodative orthotics are recommended. Diabetics who do not have numbness or circulation loss (as diagnosed by their doctor) do not need to have accommodative orthotics. If the foot has a deformity, like a bunion or hammertoe, then accommodative orthotics are necessary.
Accommodative orthotics are made from many different types of material. Some are made of a foam type material, others made from cork and others have covers ranging from soft spongy material to leather. The type of material depends on the type of foot. Many accommodative orthotics, made for diabetics, have two or more layers that form around the foot once they are worn. Three pairs are dispensed every year and they are replaced every 4 months. Other materials are longer lasting. A mold of the foot is taken by stepping into a foam box. In this case, it is important to take the mold standing, so that the orthotic can be made to form around the foot.
Many insurance companies cover orthotics for certain diagnoses. The most commonly covered diagnoses are plantar fasciitis (heel and arch pain), flatfeet and diabetes. Many insurance companies cover the orthotics at 80%. This means the patient is responsible for 20% of the cost unless they have a secondary insurance. If the deductible has not been met, then the amount is applied to the deductible and the patient must pay the full amount. Orthotics are not cheap. They range from $250 to $600.
Medicare covers orthotics for diabetics with neuropathy (numbness of the feet). Medicare does not cover orthotics for any other type of foot problem. Secondary insurance will not cover orthotics if Medicare does not cover them.
Podiatrists most commonly prescribe orthotics, but pedorthotists, orthotists, physical therapists and sometimes orthopedists will also provide orthotics.
Christine Dobrowolski is a podiatrist and the author of Those Aching Feet: Your Guide to Diagnosis and Treatment of Common Foot Problems. To learn more about Dr. Dobrowolski and her book visit http://www.skipublishing.com. For more information on prefabricated orthotics visit http://www.northcoastfootcare.com.
This RSS feed URL is deprecated, please update. New URLs can be found in the footers at https://news.google.com/news
Commentary: The Tribune was wrong. Medicine often involves a risk to the patient. - Salt Lake Tribune
Rethink Healthcare: Government hospitals must provide quality, affordable medicine - Economic Times (blog)
Landmark CAR-T cancer study published in the New England Journal of Medicine - EurekAlert (press release)
The Right Medical Equipment For You Home Or Practice!
Quality, dependable Medical Equipment is an important component of every medical practice. It can't be overstated that while the practice of medicine is an art, Medical Equipment is the science behind the implementation of that art.
The 7 Most Dangerous Mistakes You Can Make When You See a Doctor for Arthritis!
1. Seeing a doctor who's not board-certified or a doctor who isn't really an arthritis specialist.
Cholesterol Prescription Medications Can Kill You
While there are numerous options for people to lower cholesterol naturally, thousands and thousands of people are taking prescription medication to lower cholesterol - risking some very dangerous side effects.These side effects can include:? An increase in cancer risk ? Elevated liver enzymes (causing liver damage) ? Yellow skin / yellow eyes ? Rhabdomyolysis (degenerative muscle tissue condition) ? Impaired kidney function ? Muscle weakness and pain ? Dizziness ? Gas ? Headache ? Heartburn or indigestion ? Nausea or vomitingCrestor, a prescription medication to lower cholesterol, has been linked to the death of a patient who developed a suspected case of severe muscle wasting.
Rheumatoid Arthritis : the time bomb
The beginning is very much hard to spot as we migh just wake up in the morning and feel that the fingers on our hand do not function as they should. A little of bit of movement and everything is fine.
First Responder Human Hibernation Units
In the next few years paramedics, first responders and military medics will have instant hibernation devices. These devices will come in small canisters of the gas to slow the body down after replacing lost blood and/or stopping bleeding.
Hypertension & High Blood Pressure: How To Improve Life Threatening Weight-Related Diseases
The American Heart Association estimates that one of three Americans have have hypertension. And yet many of us don't know what it is, why it's dangerous, and what the treatment options are.
Rebound Headache - Stop The Cycle
You've been getting headaches. Finally, you find some medications that are making a difference.
Physicians, Chiropractors and Physical Therapist Agree on a New Treatment for Low Back Pain
One of the most prevalent and difficult health conditions to treat in the physical medicine is low back pain. The difficulty in treating low back pain comes from the fact that there are numerous causes including herniated discs, bulging discs, degenerative discs, muscle spasms, facet arthritis, and sciatica.
Considerations in Distance Education for the Medical Assistant Instructor
Medical Assistant distance education is emerging to meet the demands of a new generation of students in the twenty first century. St.
Anxiety Management With Prescription BuSpar: Don't Worry, Be Happy
We've all had one of those weeks: the washing machine overflows, the dog forgets his housetraining and the toddler her toilet training, the boss is going through a divorce and making everyone miserable. And you feel like you just don't know how to handle it all.
10 Tips for Responsible Medication Use
All medications, which include prescriptions, over-the-counter preparations, vitamin and mineral supplements, and herbal preparations, are potentially dangerous. Following some simple rules will not only reduce your chance of having a problem, but should reduce your cost as well.
Adaptogens for Life - The Science Behind the Discovery of Adaptogens
Modern civilization has produced an unusually stressful environment to humans and animals, with extreme high demands on our physical and mental abilities. The last one hundred years have brought unique new challenges for all.
Strong Pain Relief - Powerful & Effective Natural Pain Management Alternative
The recent removal of several high profile and popular prescription pain medications of the same pharmaceutical family, nonsteroidal anti-inflammatories, from the buyer's market has left many people searching for a safer alternative for powerful, fast and effective pain relief. The most recent removal was Pfizer's pulling of Bextra, citing serious skin reactions, sometimes fatal, and two others, Vioxx and Celebrex have been linked to heart related risks.
Online Pharmacy Watch: DEA Does Spring Cleaning Of Illegal Internet Pharmacies
Since early 2004, it has become more apparent every day that the online pharmacy industry is being destroyed. Who is doing such damage to bring the industry crashing down, you ask? So far, the people responsible are savvy businessmen who are using their skills to create temporary safety nets for black-hat operations using loopholes in international security.
Are Drug Companies Destroying The U.S. Health Care System?
A Look at the Different Acid Reflux Symptoms
Acid reflux symptoms vary in degrees of discomfort, from person to person, and within different age groups. The most common and persistent symptom is a burning sensation centered in the middle of the chest and/or throat, brought on by stomach acid that churns up onto the lining of the esophagus.
Give Me Accutane or Give Me Death: The Politics of Prescriptions
Any teenager will tell you that acne can drive you crazy, but is it dismal enough to drive you to kill yourself? Since its market debut in 1982, enraged parents and lawyers have implicated Accutane in the hospitalizations and suicide deaths of over 200 teenagers in the US.Accutane (isotretinoin) is one of Hoffman-LaRoche's most popular and controversial pharmaceuticals.
Medication Compliance Kit ... A Life Saver
Pill Proof LLC introduces the first, easy to use medication compliance kit for consumers and medical professionals. Owner, Jane Langdon, has a sister in law with Parkinson's Disease.
The Check Doctor Credentials Theory
In 2003, there where more than 890 million doctor visits in the U.S.
Viga Lies Cause Potential Fatalities
Viga and Viga for Women is a dietary supplement sold OTC and via the internet that marketed itself not as a prescription drug but as a dietary supplement pill. It was a dietary supplement version of Viagra, which is a drug for erectile dysfunction.
|home | site map | Dr. Thad Thomas|