Treat Your Feet to Proper Insoles
What IS the "Proper" insole for me???
How much are these going to cost? Why do I need something expensive when I can just go to the store and buy something that does not cost nearly as much? These temporary arch supports seem to be working fine. Why do I need a prescription device?
Do you ever hear any of these questions when speaking with a patient? You are not alone. For some, it is very difficult to explain the difference between an "over the counter" or "temporary" insert and a prescription orthotic.
To begin, most foot problems are due to genetics. Patients are often surprised by this information. The inherited foot structure, aggravated by things like activity, shoe selection, body weight, uneven surfaces, etc. result in an eventual overuse injury. It is really a "strain" of the foot caused by overuse. Overuse is different for everyone. When things start to hurt, it signals that there is often an "overuse" type of injury. When your Podiatrist examines the patient and reviews the x-rays, he or she can then diagnose the problem. Usually, the first line of treatment is something to calm down the inflammation (NSAID, cream, oral steroid, or a steroid injection) and then something for the underlying cause. That is where TEMPORARY support comes in. Taping/strapping, over the counter arch supports, store-bought inserts, and shoe modification are all temporary ways to support the foot.
When the patient returns to the office, for their follow up appointment, that is where the “next step” discussion starts. Most often the patient is feeling better and their problem is on the mend. They are happy until they hear that they need something else. It is important to make sure you educate the patient on their foot condition. Help them understand why their foot feels better at this point while explaining the possibility of the pain likely returning without properly supporting the foot.
Our doctors strongly recommend prescription orthotics for long term support, to slow the deformity and pain progression. The idea of a "permanent" device needs to be explained, along with the reason that they are better. Orthotics are a true "prescription," just like eyeglasses. Temporary or "over the counter” inserts are just arch supports, similar to reading glasses. They might help a little in some circumstances but will not last. We see a LOT of patients with a return of their foot pain when their temporary inserts wear out. Temporary inserts are just that, temporary. They will wear out and need to be replaced usually every 3-6 months depending on activity level. An orthotic will last years, in most cases. This information is key when explaining to patients the benefit of moving into a prescription orthotic. If a patient must replace their temporary supports 2-4 times a year, that cost will add up. The patient would be making a better investment in their feet with a prescription orthotic.
For this reason, it is vital to explain the need to properly support and protect the foot and maintain a good foot structure and support with a prescription orthotic and a good shoe whenever possible. While you will need to consider the cost of a prescription orthotic, will also need to consider the pain from lack of proper support. Do yourself a favor and treat your feet to proper insoles.
April Foutz, PMAC, PRAC, RMA
Back Office Manager
Indiana Podiatry Group