Foot orthotics are commonly used to treat a range of foot problems from overpronation and collapsed arches to plantar fasciitis and other causes of heel pain. The scientific evidence shows that they are generally effective at fixing a lot of the problems as long as they are indicated for that problem, Foot orthotics generally get used to support the foot, when support of the foot could have nothing to do with the problem that the person may have. This can lead to them being misused and mistakenly blamed for treatment failures. The other problem is that there are many different types of foot orthotics and also within each kind of foot orthotic, there is an practically infinite variance in the design features which might be included in them. If even one of those design features isn't right for the individual, then the prospects of that foot orthotic helping is probably reduced. For this reason the option of the different designs is actually based upon the experience and expertise of the clinician.
The clinician will select the design features needed for the individual and if the device needs to be custom made for the individual or if a pre-made less costly foot orthotic can be used. With regards to custom made orthoses, the podiatrist needs to take a plaster cast or optical scan of the foot kept in specific positions for the foot orthotic to be made on. When it comes to the design of the device various elements are evaluated. For example, if the patient has posterior tibial tendon dysfunction, then something like a MOSI type foot orthotic is necessary. The MOSI has specific modifications to handle the range of problems that occur in that condition. When the concern is associated with a lack of impact absorption, then the orthotic has to be designed to cater to that. The plethora of choices is endless and is dependent upon the problem present and the wishes of the treating clinician.