Orthotic

An orthotic is a device worn to modify the structural and functional characteristics of the musculoskeletal system. Orthotics can be custom-made or prefabricated and are used to support, align, prevent deformity, or compensate for impaired function of a body part, most commonly the foot and ankle.

Foot orthotics, or insoles, are the most common type and are designed to fit inside shoes to correct arch alignment, redistribute plantar pressures, or cushion the sole. Other forms include ankle-foot orthoses, knee-ankle-foot orthoses, and spinal braces such as scoliosis orthotics.

Manufacture and fitting typically involve assessment by an orthotist or other clinicians, such as podiatrists or physical therapists. Fitting may include measurements, foot and gait analysis, and sometimes imaging. Custom devices are tailored to the patient; prefabricated versions are adjusted to fit.

Materials range from rigid plastics and carbon fiber to soft foams and elastomeric compounds. The choice depends on the desired rigidity, support, weight, and comfort.

Indications include flat feet, plantar fasciitis, metatarsalgia, arthritis, diabetic neuropathy, foot ulcers, neuromuscular conditions, and post-surgical stabilization. Orthoses may also be used to prevent injury in athletes and to assist with gait abnormalities.

Functions include redistributing pressure, correcting malalignment, restricting motion, and improving balance and walking efficiency. By altering loading patterns, orthotics can reduce pain and slow the progression of certain deformities.

Risks and considerations include skin irritation or breakdown, pressure points, allergic reactions to materials, and poor outcome if improperly fitted. Regular follow-up, proper wear schedules, and device maintenance are important for safety and effectiveness.

Evidence for effectiveness varies by condition. There is robust support for certain foot conditions such as plantar fasciitis and diabetic foot offloading in appropriate cases, while results are mixed for others, highlighting the need for individualized assessment and monitoring.