Orthotics have been a subject of debate within the scientific community, and my own experience working with them has been varied [1]. During my time as a student at the school clinic, we collaborated with an orthotics company and utilized their products on several patients, yielding mixed results. One memorable case involved a patient suffering from chronic pain in the balls of their feet. Using orthotics helped redistribute the weight load, offering significant relief while we addressed underlying issues with their hips and low back. However, once those issues were resolved, the orthotics began causing foot and back pain, prompting us to discontinue their use. In such cases, I now opt for more affordable alternatives like Dr. Scholl's inserts as a temporary measure in the treatment process.
In my experience, orthotics often serve as temporary solutions to alleviate pain while underlying biomechanical issues are addressed. They can be likened to NSAIDs like ibuprofen for muscle pain or headaches, providing relief without notable side effects. Working across from the Portland Ballet Company exposed me to individuals who relied solely on the natural support of their feet, as orthotics were not an option. These dancers, despite having asymmetrical bodies and various musculoskeletal abnormalities, developed incredibly strong foot musculature to support and balance their bodies effectively.
While strengthening the feet to provide natural support is an ideal scenario, there are instances where orthotics are necessary. For example, I recently treated an elderly patient with low back pain stemming from a foot deformity, where orthotics were highly recommended. Similarly, conditions like diabetes, poor circulation, and arthritis may warrant orthotic use. However, even in these cases, orthotics may serve as temporary aids while patients continue their treatment and work towards improving overall health.
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