Some (if not most) people are fortunate enough to be able to buy a new pair of shoes and simply wear them with comfort—because the shoe provides sufficient support to their arches, ligaments, bones, and joints. Others are less fortunate, and most new pairs of shoes aren't complete without an orthotic insert. But what's the difference between just needing an orthotic insert and actually requiring custom footwear to compensate for an orthotic issue?
Firm or Flexible
Orthotic inserts can be firm, helping to correct the positioning of the foot while wearing the shoe. They can also be flexible, with a cushioning effect that acts as a shock absorber, while also giving support to fallen arches (flat feet), and minimizing the effects of plantar fasciitis, which can cause inflammation of the connective tissues that support the arches.
Certain orthotic conditions are compatible with most types of shoes, and the only required addition is an orthotic insert. These conditions are largely limited to the soft tissues, muscles, and ligaments of the feet. An abnormality of the bones of your feet are a different matter.
The Bones of Your Feet
When the configuration of the bones of your feet has resulted in an abnormality, you may not be able to physically wear a standard shoe. You can have difficulty in even finding a shoe that fits, and wearing an unmodified shoe can cause discomfort (not to mention lasting damage). Overcoming such a problem isn't just a case of adding an orthotic insert to the shoe either.
Accommodating a Bone Abnormality
An abnormality of the bones of your feet must be accommodated, and this involves custom footwear. For example, a patient with diabetes may develop neuropathic arthropathy, causing the resorption of some of the bone mass in their feet. Such a case can be managed with custom footwear, with the contours of the interior of the shoe designed to compensate for the specific bone abnormality. In fact, the overall design of the shoe is intended to compensate for the abnormality. This involves features such as rocker sole to create a smoother, more comfortable stride, while the necessary support for the feet is integrated into the construction of the shoe—which, to the untrained eye, looks just like a regular shoe.
Orthotic inserts can assist with a range of foot problems, but when there's an abnormality relating to the bones of your feet, an insert isn't going to be sufficient. If you've been wrestling with foot pain regardless of the type of shoes you're wearing (and any inserts you're using), it might be that instead of an insert, your particular problem needs a more customized solution.