A person with chronic foot pain wrote to me recently asking if custom orthotics would help her chronic foot pain.  Please see my responses in italics

I am currently 52 years old and have suffered with foot pain for 20 years. I used to do quite a bit of running in my 20’s and 30’s. After pain developed in the ball of both feet and in my heels, I gave up the running and walked for exercise. At the age of 37, even the walking brought on pain (as did standing for long periods of time). I have been to numerous doctors and podiatrists over the years (Scripps, UCSD, various podiatrists) and have had several different custom orthotics made. Most of these were of the very rigid plastic variety, and all but one caused me so much discomfort that I finally quit using all of them after many months of use for each orthotic. The only exception to this pattern was a custom orthotic made by Scope (recommended by a UCSD doctor) back in 2001. This particular orthotic was made of a very dense and firm foam-like material which was flexible if bent. While it didn’t get rid of all my pain, it did help me get by for several years until they wore out. However, they were very expensive and were not 100% effective – so I haven’t tried to get another pair from them since.

Do you have any other conditions that might be responsible for your foot pain, for example, Rheumatoid Arthritis, Gout or any other chronic inflammatory conditions?  Do you still have the pair of orthotics even if they are deteriorated?  I can make soft, foamy orthotics which work well for people with chronic foot pain or neuropathy.  I can also make flexible, semi-flexible or hard custom orthotics.  I choose the firmness and density of the material based on the persons condition(s) and orthotic history.  In your case your have already tried many hard plastic orthotics that did not work and experienced the best relief with the foam orthotics so that is exactly what we would make for you.

I found your website a while back and read about your use of flexible and semi-flexible orthotic materials. The last time I had a custom orthotic made was in 2013 by a local podiatrist. The resulting product was another rigid hard plastic orthotic with a full-length pad on top which caused even more foot pain right from the start. The doctor tried to modify it several times, but finally gave up. Since then, I have rotated between older pairs of orthotics that I have on hand to alleviate my pain. The pain is no longer confined to just my feet. In fact, I actually get more pain in my knees and hips now than I do in my feet. When the pain gets bad enough, I switch to another orthotic in my collection and it usually (temporarily) relieves my pain condition for a few days. However, at that point the pain starts up all over again and grows worse until I switch again to a different pair of orthotics. And the constant switching between orthotics is not working as effective as it used to.

I have seen this exact type of situation a few times over the years.  For some reason CHANGE is a positive for you and then after a little bit of time it does not work anymore.  I believe this happens because change is a good thing.  For example, if you are sitting at a computer in one position for too long it becomes uncomfortable.  Maybe your back or your butt begins to hurt so you shift and change positions.   It appears your orthotics will shift pressure from one area to another helping a little…….but then you have to shift again.

Based on what I have told you, do you believe that I am a good candidate for your type of foot orthotics? If you don’t think so, then I would like to know that too. I have postponed seeking treatment again for some time due to the cost of custom orthotics. (I am self-employed and draw custom house plans for a living, but the cust