At a time when you can receive a flu shot, eye glasses and wart removal during a quick trip to the drugstore, it's no surprise that you can now get a pair of orthotics too.
Orthotics kiosks are popping up at pharmacies throughout the country — CVS has one at many of its stores, Walgreens too — and while they're convenient, they're also controversial to doctors and physical therapists.
On the up side
A recent study published in the British Journal of Sports Medicine finds that people with knee pain have fewer aches when they popped in a drugstore-type orthotic than when they went without it.
The orthotics look like shoe inserts and are placed inside your shoe to add extra support and help with arch problems. They're geared toward people suffering from foot pain that can arise from having flat feet, wearing uncomfortable shoes or simply walking or running incorrectly, among a host of other reasons.
On the down side
"The big problem with solving your own foot problem is that most people aren't able to correctly figure out the source of their issue and assume that grabbing a pair of inserts would get rid of the pain," said Robroy Martin, a physical therapist at University of Pittsburgh Medical Center's Center for Sports Medicine.
"If you get an orthotics without a recommendation, it could make your symptoms worse," Martin said. "A lot of times, the foot problems can come from a weakness in your core or your hips, or the flexibility of your hip muscles. Your foot pain is the end result of those problems."
By simply popping a pair of orthotics into your shoes, you may temporarily halt the pain, but you're probably not solving the problem. Martin said that a physical therapist can perform a full-body screening for muscle imbalances to figure out the mechanics that are manifesting themselves as foot pain.
The physical therapist could also suggest stretching exercises or even a pair of more supportive shoes.
If orthotics are recommend for you, you have a choice: a custom-fit pair created to fit your feet and your health problem, or a pair from CVS, Target or nearly every other store selling medical items.
The major difference is price.
A good over-the-counter pair may be $30-$40, while a custom set could run $400-$600, said Dr. James Christina, a podiatrist and director of scientific affairs for the American Podiatric Medical Association.
Some insurance coverage will cover orthotics, but it will typically only reimburse you for the custom orthotics, not the over-the-counter ones, Christina said.
The reason there's such a difference in price has to do with the customization and materials used when making the orthotics, said Christina, adding that custom orthotics should last about three years, while the over-the-counter versions typically wear out after six months.
If you do decide to try the over-the-counter orthotics, Christina suggests finding one with a plastic polymer or a hard plastic that's a little more rigid than just the typical shoe insole.
Some orthotics sold at drugstores are made from softer materials that flatten as soon as you step onto them. The problem is that is that they're not giving you any more support than you'd be getting from your own shoes, Christina said.
You could opt for a blend between over-the-counter orthotics and custom-fit ones by trying a moldable over-the-counter brand such as REI's SOLE Thin Sport Custom Footbeds ($45 at rei.com).
To mold the inserts to your feet, heat them in the oven for two minutes, put them into your shoes and then stand in your shoes for two minutes.
"This falls in between an off-the-shelf one that hasn't been modified, and a true custom," Christina said. "It's better than a straight over-the-counter, but the problem is depending on how well the molding takes place. The theory behind a true custom foot orthotic is that when an impression is taken, you're holding your foot in the impression that it should be in properly."
Still, the problem remains that custom orthotics are made to help with a specific amount of pronation (misalignment of a foot due to a low arch), and the over-the-counter inserts may simply not do the job properly.
"We fill prescriptions for devices, and the type of device has to do with the severity of your symptoms," said Thomas DiBello, certified orthotist in Texas.
If your symptoms are minor, you can try an over-the-counter pair first, he said.
"If someone says, 'My feet feel tired at the end of the day,' it's probably appropriate to go to a kiosk," DiBello said. "However, if they get out of bed one morning with severe pain in their heel and can't walk without pain, they should see a physician."
Average lifespan of custom orthotics
Average life span of over-the-counter orthotics
SOURCE: Podiatrist James Christina