Health Team

Foot pain needs a podiatrist's touch

Custom inserts, or orthotics, can help relieve foot and ankle pain. But getting a correct diagnosis from an expert podiatrist is essential to the right fit.

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RALEIGH, N.C. — Many drug and shoe stores offer special shoe inserts costing hundreds of dollars as a remedy for foot and heel pain.

Getting fitted for a custom orthotic, or insert, involves stepping on a machine that scans feet to determine the kind of orthotic needed. However, the wrong diagnosis and orthotic can make the pain worse.

Cherrel Cortopassi experienced that problem and saw a physical therapist for foot pain. The therapist said her problem was flat feet.

"I waited... a week or 2 weeks, and they provided me with a $600 orthotic," Cortopassi said. But the insert increased her pain.

Podiatrist Dr. Jeremy Thomas, with Triangle Foot and Ankle, said many such orthotics aren't actually custom-made, and shoes salespeople and physical therapists aren't really qualified to diagnose foot pain problems.

A proper diagnosis requires an expert exam by a podiatrist who looks at all the joints from the knee down to the toe. Thomas also takes a look at how the patient walks.

"It really gives me a full idea of where her foot should be in a custom orthotic," he said.

Before fitting Cortopassi for an orthotic, Thomas let her try an inexpensive insert.

"He said, 'We're going to start out with this and see if it helps,' but it helped immediately," Cortopassi said.

In fitting for an orthotic, Thomas starts with a plaster mold, capturing the arch of the patient's foot in a neutral position. The mold hardens in minutes.

A real custom orthotic made from a cast will keep Cortopassi's foot in the neutral position. Unlike the over-the-counter version, Cortopassi said, the custom orthotic provides support and relieves pain.

Most insurance policies will cover custom orthotics.

Make sure to see a podiatrist who can diagnose whether foot pain can be relieved by an orthotic or if it is caused by a more serious condition.