From the Guidelines
Orthotic inserts are indicated for individuals with diabetes who are at risk of foot ulceration, particularly those with foot deformities, pre-ulcerative lesions, or a history of plantar foot ulcers, as they can help reduce plantar pressure and prevent ulcer recurrence. According to the most recent guidelines on the prevention of foot ulcers in persons with diabetes 1, orthotic interventions, including therapeutic footwear, custom-made insoles, and toe orthoses, are recommended for individuals with diabetes who are at risk of foot ulceration. The indications for orthotic inserts include:
- Foot deformities that significantly increase pressure
- Pre-ulcerative lesions
- Healed plantar foot ulcers
- Individuals with limited foot deformity, no pre-ulcerative lesion, and no plantar ulcer history (IWGDF risk 1-3) may also benefit from orthotic inserts, but the recommendation is stronger for those with higher risk factors 1. The use of orthotic inserts can help reduce the risk of foot ulceration by redistributing pressure, providing cushioning, and supporting the arch 1. It is essential to educate individuals on the proper use and fitting of orthotic inserts, as well as the importance of consistently wearing them in appropriate footwear 1.
From the Research
Indications for Orthotic Inserts
The indications for orthotic (orthopedic) inserts are varied and include:
- Patellofemoral osteoarthritis, as foot orthoses are a recommended treatment for this condition 2
- Plantar fasciitis, with studies showing that prefabricated foot orthotics can reduce pain and improve function in adults with acute plantar fasciitis 3, 4
- Foot and ankle conditions, such as arthritis, neuropathy, and foot and ankle trauma, where orthotics can play a significant role in treating these conditions and preventing progression 5
- Overuse injuries, such as those resulting from running, where orthoses and shoe inserts are widely prescribed to alter the pattern of lower extremity joints' alignment and movement 6
- Connective tissue disorders, tendon and ligament injuries, and sports-related recurrent injuries, where orthotic management has proven effective 5
Conditions Treated with Orthotic Inserts
Orthotic inserts can be used to treat a range of conditions, including:
- Lower limb osteoarthritic conditions 2
- Plantar fasciitis, with prefabricated foot orthotics showing significant effects on pain levels 3
- Foot arthritis, where orthotic treatment can help alleviate pressure on affected areas 5
- Neuropathic and inflammatory wounds, where orthotics can help promote normal gait and prevent progression 5