A prescription foot orthotic is an in-shoe brace which is designed to correct abnormal foot and lower extremity function. In correcting abnormal foot and lower extremity function, the prescription foot orthotic reduces the strain on injured structures in the foot and lower extremity, allowing them to heal and become non-painful. In addition, a prescription foot orthotic helps prevent future problems by reducing abnormal or pathological forces acting on the foot and lower extremity.

Podiatrists prescribe two main types of prescription foot orthotics for their patients, accommodative orthotics and functional orthotics. Both types of prescription foot orthotics are used to correct foot function of the patient, so that the pain in their foot or lower extremity will improve. However, accommodative and functional orthotics are generally made using different materials and may not look or feel the same. Both types of prescription foot orthotics are nearly always prescribed as a pair to allow more normal function of both feet.

Accommodative foot orthotics are used to cushion, pad or relieve pressure from a painful or injured area on the bottom of the foot. They may also be designed to try to control abnormal function of the foot. Accommodative orthotics may be made of a wide range of materials such as cork, leather, plastic foams, and rubber materials. They are generally more flexible and softer than functional foot orthotics.

Accommodative orthotics are useful in the treatment of painful calluses on the bottom of the foot, diabetic foot ulcerations, sore bones on the bottom of the foot, and other types of foot pathology. The advantages of accommodative orthotics are that they are relatively soft and forgiving, and are generally easy to adjust in shape after they are dispensed to the patient to improve comfort. The disadvantages of accommodative orthotics are that they are relatively bulky, have relatively poor durability, and may need frequent adjustments to allow them to continue working properly.

Functional foot orthotics are used to correct abnormal foot and lower extremity function. Some types of functional foot orthotics may also be designed to accommodate painful areas on the bottoms of the foot. Functional foot orthotics may be made of flexible, semi-rigid, or rigid plastic or graphite materials. They are relatively thin and easily fit into most types of shoes.

Functional foot orthotics are useful in the treatment of a very wide range of painful conditions of the foot and lower extremities. Big toe joint and lesser toe joint pain, arch pain, heel pain, and ankle pain are commonly treated with functional foot orthotics. Since abnormal foot function causes abnormal ankle, knee and hip function, functional foot orthotics are also commonly used to treat painful tendinitis and bursitis conditions in the ankle, knee and hip. The advantages of functional foot orthotics are that they are relatively durable, infrequently require adjustments and more likely to fit into standard shoes. The disadvantage is that they are more difficult to adjust.

In order to design and fabricate prescription foot orthotics, the podiatrist must perform a biomechanical examination of the feet and lower extremities. Angular measurements are taken of the toes, feet, ankles, knees and hips to determine the level and amount of any structural or functional deformities. This examination is done while the patient is on an examining table and also while standing. The podiatrist will also do a gait analysis of the patient to determine how their feet and lower extremities function during walking. Abnormalities from the biomechanical examination and gait examination are used in the design and fabrication of the prescription foot orthotics.

The podiatrist then makes three-dimensional models of the patient's feet in order to make the prescription foot orthotics. This is done by applying plaster to the patient's feet. The resultant three-dimensional models of the feet are then used, along with the detailed orthotics prescription from the podiatrist, to have the prescription foot orthotics made for the patient. Most podiatrists have a specialty podiatric orthotics laboratory make their orthotics.

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