Custom orthotics vs. Over the Counter Shoe Inserts. Which is the best for you? If you are experiencing heel, arch or toe pain, then you may have heard shoe inserts might be a solution. Your current shoes may not be offering the support that your body needs. Since your feet support your entire body, it is important to recognize that having the extra support can provide comfort and even alleviate symptoms from a variety of foot conditions and even leg and back pain. However, before you make the final decision, it’s best to understand the difference between custom orthotics and over the counter inserts (OTC). You will want to talk with Dr. Bennett about which options are best for you, and why. You want to make the best decision about your foot health. Custom Orthotics These type of devices are made from a mold of your foot, not generalized population data about foot size and shape, as OTC devices are. A visit is required to examine your foot and the specific complaints, and a decision about what type of orthotic would be best for your daily life. Then a wet plaster mold is taken of both feet, and removed when dry. This takes about twenty minutes. In my office, the dried plaster impressions are mailed out to a laboratory that manufactures the prescribed devices. They are fabricated and returned to the office, ready to be dispensed within a month. I have had many patients say their orthotics last 3 years and longer. OTC Inserts These are commercially available and can be obtained in a store, pharmacy, or online. Since there is no exam or fitting of the devices, it is difficult to match the best material and shell to the patient’s condition. They are also difficult if not impossible to properly modify, but this is the least expensive option, and they are easily replaced if they wear out or become lost. They typically need to be replaced every six to twelve months. While heel pain (plantar fasciitis) is the most common reason I prescribe custom orthotics, other conditions included neuroma, tendonitis, and quite often after a stress fracture or bunionectomy.