Billye

I have molded orthotics. I am on my second pair. the first pair was not very good but I had to make due for 2 years. They are custom molded plastic. I assume yours also have a heel cup or are more L shaped?

Regardless of the orthotic, they take a LONG time to get used to, and every time they change them, it is the same old thing, same weird sensations, same pain. I have had custom molded orthotics since 2002. I like the ones I have now, as far as being used to them, but they are not off loading my tib/fib area anteriorly and I can feel the stress. I feels very much like a stress fracture....which means I suppose I need to deal with it. I am just to tired to complain about another thing.

I have less and less sensation of contact with the floor anyway, but, orthotics may often increase the pain you have, for a while. You will feel really funny and even unstable for a while. I suggest using a walker or cane if it really bothers you. Watch your toes for clearing of thresholds or changes in levels.

If properly done, it should help your entire body alignment considerably. The key is 'properly done'. My first pair back in 2002 was not properly done.

Most insurance co. will pay for custom orthotics every two years.

The braces I pm'd you about are different....and very costly. I was shocked at the cost. Those I am sure they do not replace every two years, I assume those come with pieces that can be altered as the body changes. I am very relieved to see they make those kinds of things. I figured they should, but, didnt know they were out there and did not need all that custom casting.

I always wondered if they could make such good artificial prosthetics, why not do it for the gait impaired neuropathic....Any one with a history of unexplained fractures of weight bearing bones and a diagnosis of neuropathy, as well as inability to feel the limb, should look into those orthotics. Seeing the picture of that man crossing a finish line was inspirational.

They did cast your feet for the orthotic? It sounds like your orthotics are custom, so they must have fitted you.

I have noticed a lot of PTs lately seem a bit, disinvested or something lately...kind of like they know they can't do much of a job with the visits they are allotted by insurers...

I was fortunate that my last OT and PT were pretty good....but, it has been three and a half years on these orthotics and though they keep me from hyperpronating seriously, I can feel they are not working any more. I am going to ask about the ones I PM'd you about, and I am prepared to shell out some money....I do not expect insurance will cover the entire cost, and even the copay would be very, very steep I am sure.

I also have activity splints for my thumbs, which really do help but, once again, are very uncomfortable and limiting, but they stop the severe pain. They are white clunky things and you can't miss em'.

I also have night splints, which are custom molded, plastic, from an inch above my finger going to almost my elbow...they keep my thumb in a certain position relative to my hand and keep my fingers from contracting and my wrist from flexing, which is what happens to me if I dont wear them.

They are heavy and not comfortable, and can only be worn one arm each night, as it causes one to panic if one wakes with both arms substantially strapped into a splint that one can not get out of. Even with one on, it is very hard to get that super velcro off to free the hand...I have learned to do eye drops one handed...but opening a pill bottle requires 2 hands.

Regardless, my arms are often numb, splint or no splint...but the splints do stop the contractures that can occur when muscle spasms pull joints.

Hang in there for a while with them...I know it is like walking with a big flat rock in your shoe....it should get better. But you may have pain in joints quite a distance from the orthotic.

I know they are really hard to get used to....if things do not get better in a few weeks, call them back. Just be careful for a while so you dont lose your balance.

And stick to the usage schedule.

Im not sure how common this is but my insurance, and i believe that medicare has the same rule, will only cover orthotics for diabetic neuropathy and , not PN from any other cause. The result of all of the drug trials and research being limited to those with diabetic PN? One cause deserves treatment and another does not? I dont get the logic.

I was able to get my orthotics, all of them, covered by insurance and I do not have diabetes. I have substantial, generalized neuropathy including AN. So far, so good. What they likely won't cover for me is any immunosuppressives as everything keeps coming back with no inflammation....the nerve biopsies were quite abnormal 4 years ago and now the muscle biopsy-abnormal....so it is hard to NOT have a case for the orthotics.

I think it depends on your policy.

I have seen all kinds of splints and braces covered...however, they usually have a 2 year rule...AND...some of the better activity orthotics are not covered in full. Also, I think you will need the PT or OT referral for recommending the orthotic or brace and for fitting....One of the braces I looked at cost roughly $5K...for one. I can not imagine my insurance covering that in full.

It is likely best to call and confirm coverage, as you can get 'sold' an unreturnable device, and be stuck with a bill.....medical supply companies will often do that.

That happened with my fracture 'coil' and boy there was a fight over covering that as well....insurance did finally cover it, thank goodness. But the doctor got very fed up with the whole situation. Docs dont like to fight insurance companies and will simply discharge you or refer you on..

That said, I have seen patients have to fight for wheelchairs when they can no longer walk.