Orthotics & Arch Supports
Hypothetically, patients with low arches have a decreased ability to absorb forces caused by a foot strike. In practice, the three most common mechanical corrections were over-the counter arch supports, orthotics and arch tape. In a study of randomized treatments for plantar faciitis, orthotic and arch tape were significantly more effective than cortisone, heel cups and NSAIDs. Arch taping is the preferred treatment by almost 2% (or 2,000) of patients with plantar faciitis.
One taping session costs less than an orthotic or arch support purchased over the counter. Studies show that taping only provides temporary support. As little as 24 minutes’ worth of physical activity could reduce its effectiveness. Arch tape can be used as a treatment option or trial to determine if orthotics and arch supports are worth the cost. Taping may be a more cost-effective option for patients who have an acute onset, while orthotics and over-the counter arch supports could be a more economical choice for chronic or recurrent patients.
Athletes must retape their arches at least every time they practice or play a new game. An over-the counter arch support will last a whole season of games, while a custom orthotic can last for many seasons. Patients with mild pesplanus or acute plantar fasciitis may benefit from over-the-counter orthotics. Over-the-counter arches can provide a wide range of support depending on the materials used to construct the arch support. Patients should look for a material that is dense enough to support them while walking.
Arch supports that are available over-the-counter can be helpful for adolescents with plantar fasciitis. Their rapid foot growth may require them to buy new shoes every season, as well as arch supports. Custom orthotics can be made using a plaster cast or an impression of the foot. The insert is then made to match mechanical risk factors, such as leg length discrepancies, valgus alignment and pes planus. For plantar fasciitis, doctors often prescribe semi-rigid, full-length orthotics that have longitudinal arch support.
The two main characteristics of a successful plantar fasciitis treatment with orthotics are the need to control the metatarsal heads motion and the over-pronation of the first Metatarsal Head. A study found that 27% of plantar fasciitis sufferers believe orthotics are the best way to relieve symptoms. Orthotics are expensive and can cost up to $300 or more. Most health insurances do not cover the cost.
