Is it a Custom Orthotic or Not?

  Orthotics are medical appliances that are inserted into the shoes to effect an alteration in the biomechanical functioning of the foot and the pedal posture which in turn exerts an influence on the ankle, knee, hip and lower back.  When properly prescribed they can be a very effective therapeutic modality in treating a variety of lower extremity and related structural and postural musculoskeletal problems. Unfortunately, it seems in recent years the term "orthotic" has become diluted to mean almost any kind of an insole that is placed in a shoe with the promised hope of achieving some clinical benefit. Commercial shoe/orthotic outlets and self designated "foot specialists" and "orthotic specialists" have become all too present on many street corners and in malls offering and promising relief of foot discomfort to the ill informed. Consequently, too many people are paying for what they believe to be custom (prescription) orthotics that they either don't need or that don't work.  In all too many cases people end up paying a lot of money for mass produced shoe inserts that may have been only slightly modified, but have absolutely no therapeutic benefit --- and may in fact be harmful. At the very least, they have spent a lot of money or exhausted their health insurance coverage to purchase something with absolutely no therapeutic benefit.

   The OPMA has long maintained that patients are best served if they obtain their orthotics from a Regulated foot care practitioner, namely a Podiatrist (Doctor of Podiatric Medicine) or Chiropodist. [The term Regulated means that the practitioners are licensed by a College within the province which serves to protect the public. Accordingly, regulated professionals are accountable to the public. Pedorthists, for example, are not regulated in Ontario.]  Many insurance companies have adopted this policy as well in order to ensure value for money for any expenditures made on orthotics by their clients.

   The OPMA maintains that the prescribing of an Orthotic must entail the following:

      1. Obtaining a thorough medical history.
      2. Obtaining a physical examination.
      3. Obtaining a biomechanical evaluation including a gait analysis.
      4. Weight bearing radiographs (X-rays) - as deemed appropriate
          by the podiatrist.
      5. Plaster of Paris Non-Weight bearing Negative Casts taken in sub-talar neutral             
      6. The Orthotics should only be fabricated by an accredited Orthotic
          Laboratory.
      7. A clearly outlined follow-up regimen with the practitioner to
          ensure proper functioning of the devices and a good clinical outcome.

 The OPMA has worked together with our regulating College and insurance
companies to ensure that certain guidelines and standards are met in the prescribing and fabrication of orthotics in order to attempt to prevent fraudulent claims and over-utilization. In addition, for these reasons the OPMA continues to lobby the Ontario government to make the prescription and dispensing of Orthotics a controlled act under the Regulated Health Professions Act.

Please follow the link below to a CBC Marketplace program that resulted from
an investigation into the prescription and dispensing of orthotics ---- and play it safe by having your feet examined and any foot ailments diagnosed by a registered Podiatrist (Doctor of Podiatric Medicine).

       http://www.cbc.ca/marketplace/sole_patrol/  CBC Marketplace Investigation