Many of my patients come in and they’ve already tried icing, they’ve tried anti-inflammatories, they’ve tried other types of treatments for their heel pain and they’re not getting better. I tend to explain to patients that orthotics are usually the first line of treatment after you’ve tried some other things.  For example, I explain for treating heel pain there are three components. You have to reduce the inflammation, you have to loosen up the calf muscles and you have to stabilize the heel.  They all work in conjunction and if you’ve already tried a cortisone injection and anti-inflammatories and ice to reduce the inflammation and you’re doing physical therapy or deep tissue massage to the back of the calves, and you’ve tried good shoes, then that’s the time to use custom orthotics, especially if your heel position is unstable or if the heel goes in or outward. That can be very beneficial.  So in my opinion I don’t think everyone needs orthotics, but if you’ve already tried other things, a custom orthotic tends to be very helpful.  Bear in mind that a custom orthotic is different than an over-the-counter insert.  An over-the-counter insert isn’t able to stabilize the heel.  They usually just give a cushion in the heel and a little arch support.  

To Your Health,
Dr. Donald Pelto