Online question – custom made orthotics
"I’ve just been to a podiatrist for the first time – he is a private podiatrist. I had an ankle injury which has also affected my instep ligaments – this has all just come about in the last 8 months after I went over on my ankle … since then I have now gone over on my ankle three times. The podiatrist was very good and advised custom made orthotics for my feet as they have become more flat footed and slightly painful (and also affecting my knees, lower back and upper back). He has quoted £300 for this – I didn’t realise they would be so expensive. Can you tell me if I would be better to go to my doctor and be referred to the NHS for this instead as £300 is a lot of money."
Answer
Custom made orthotics/insoles are expensive … unfortunately. They are like prescription glasses, they are made to your specific prescription in the lab and anything which goes through a lab once only will be expensive. Anywhere between £250-£400 is about the norm for custom made orthotics. It depends which system the podiatrist uses and which lab they use. As a comparison my fees are £215 for the custom orthotics and £100 for a full biomechanical assessment and computerised gait analysis.
Custom made orthotics might well be the route you have to go down, however … you could try over the counter orthotics first and see how much of the pain and discomfort they remove and how comfortable they are. Unless there is a very specific reason I mostly suggest over the counter orthotics to my patients first to trial them out. Of course the downside is that they might not be supportive enough for you or they might not be functionally accurate enough for you and you will still have to go down the custom orthotic route. Over the counter orthotics suit many people, just not all.
By all means go to your doctor and ask for a referral. In some areas you can self refer. Sometimes you can wait months to see an NHS podiatrist and then even longer for the orthotics to arrive. Some trusts produce excellent custom made orthotics but unfortunately others produce what I would call a very poor attempt at a "custom" orthotic, something not much more than a floppy insole with bits of felt stuck on to it. It’s the luck of the draw really.
There are many types/makes of over the counter orthotics. What’s best? Depends what you want the orthotics to for and the type of shoes they are to go in – sport, general everyday, diabetic. If general orthotics for every day then I suggest 3/4 Superfeet for ladies
(and Superfeet 3/4 for Men
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