Sep 28

Written by: Larry Huppin, DPM
9/28/2009 6:31 PM

Occasionally, a patient will develop back pain secondary to wearing new foot orthotics. We have a recommended protocol for dealing with this situation.

First, if back pain is going to occur, it will usually happen during the first couple of weeks the patient is wearing their new orthoses.  When patients complain of back pain during the orthosis break-in, we use the following protocol:  

• When symptoms first occur we have the patient stop wearing the orthoses until the pain is 100% relieved.
• Once the pain is gone, we have the patient start wearing the orthoses again, but instead of the standard break-in of one hour on day one and increasing by one hour per day, we start with only 15 minutes on day one and then increase by 15 minutes per day.
• If pain starts again, the patient is instructed to stop wearing the foot orthoses and call us immediately.
• If back pain does return we decrease the control of the orthosis by thinning the arch to increase flex. Sometimes we also remove the rearfoot post.

Well over 90% of these patients are now able to wear their orthoses comfortably. For those that still develop back pain with orthotic use, we will have the patient stop wearing the orthoses and refer them to a physiatrist. Sometimes the patient can break back into the orthoses after working with a physiatrist and physical therapist. We will try other therapies for their foot complaint.

If the patient is unable to wear their orthoses we refund the cost of the devices to the patient (our policy is to guarantee that the patient will be able to wear orthoses comfortably). This is a cost of doing business -- I’d rather refund their money than have an unhappy patient. We do not return these orthoses to the lab and would never expect the lab to refund the cost of the devices as long as they were made as we prescribed.

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