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Orthotics are a special brace, shoe insert, or other device to help with foot, leg, or back problems. Your doctor, chiropractor, or physical therapist can prescribe orthotics and give your instructions for when and how to wear them. You may also hear the term orthosis or orthoses.
Orthotics are used to:
Examples of common orthotics include AFO braces, heel lifts, and SMO braces.
An ankle foot orthosis (AFO) is a leg brace that supports the leg and foot. It goes from just below the knee to the end of the foot to make an L-shaped frame.
AFOs help control the position and motion of the ankle and foot and support weak muscles. They can also be used for patients with contracture, a condition in which joints become stiff or tight.
For people with cancer, AFOs can help with foot drop due to chemotherapy-induced peripheral neuropathy. Foot drop is the inability to lift the foot due to muscle weakness or paralysis. The AFO helps patients lift the foot while walking to decrease the risk of tripping and falling.
There are different types of AFOs. Your doctor or physical therapist will recommend the type that is right for you.
A heel or shoe lift helps patients who have one leg that is shorter than the other (leg length discrepancy). If the leg length discrepancy is small (3 centimeters or less), the patient may only need a heel lift. A heel lift is a wedge placed inside the shoe of the shorter leg. If the discrepancy is large (greater than 3 centimeters), a shoe lift is needed. The shoe lift is placed on the outside of the shoe.
A custom shoe insert is a device placed inside a shoe that is made from a mold taken of the person’s foot. The inserts are made to meet a patient’s specific needs. Custom inserts may be prescribed to correct foot and ankle motion, give cushion and support, or treat pain in the foot, ankle, knee, or back. Inserts may be made from a firm or semi-soft material.
A supramalleolar orthosis (SMO) is a type of leg brace that supports the foot to just above the ankle bones. This orthotic is often used for children who have very flexible, flat feet which can make the foot pronate or roll inward. SMOs help position the foot for standing and walking. They are usually made of flexible plastic with a foam or silicone liner for comfort.
A thoracolumbosacral orthosis (TLSO) is a back brace that supports the spine and keeps it from moving. A TLSO fits from the middle of the chest down to the tailbone. It is usually made of hard plastic with a foam liner for comfort. A TLSO can be used to keep the spine stable after surgery, to correct spinal problems, to help the spine heal, or to protect the spine from injury.
A shoe insert is a non-prescription or “over-the-counter” insert worn inside a shoe. Shoe inserts can be found at pharmacies and specialty shoe stores. They are mass produced, meaning they are not customized for a person’s foot. Shoe inserts are typically made of gel, foam, or plastic. They can make shoes more comfortable and give support. Over-the-counter shoe inserts are not designed to correct major foot problems.
A few common types of shoe inserts include:
Always follow the instructions for your specific type of orthosis.
Every day, wash the skin covered by the orthotics and inspect the skin. Check for irritation such as redness, bruising, blisters, or calluses. Let your care team know if you notice any skin change or problem.
You need time to get used to your new orthotics. Your health care provider will give you a wear schedule to allow your body to slowly adjust. Some soreness in your feet, legs, or back is normal at first. Gradually getting used to the orthotics can help prevent or reduce discomfort.
A gradual “break-in” or “wear-in” period can help you adjust to your orthotics. Always follow the specific instructions given by your health care provider.
Insurance will often pay for orthotics if there is a medical need. In most cases, your doctor or physical therapist will need to prescribe the device and provide documentation. This is known as a Letter of Medical Necessity or a Doctor’s Statement. Each insurance plan is different, so check with your insurance company to learn more.
Reviewed: September 2022