Foot pain and orthotics: when to get assessed and what may be covered

Flat feet, heel pain and footwear concerns do not automatically mean someone needs custom orthotics.

Adapted from a guide first written for Quebec readers: passages specific to Quebec were removed. Rules in your province may differ.

Foot shape alone does not tell you whether an orthotic device is needed. In young children, a low arch can be part of normal development. Pain, stiffness, a marked difference between feet or a change in walking are more useful reasons to ask a health professional for an assessment than a photograph or sales pitch.

Separate comfort from a health assessment

Start with the problem you want to solve: where it hurts, when it began, what activities trigger it and whether swelling, numbness or a change in walking is present. A family doctor, nurse practitioner, physiotherapist or podiatrist can advise which assessment is appropriate. Bring shoes you use regularly and any relevant medical history. Do not assume a custom device is necessary before a qualified professional has assessed you.

Ask before buying

• What condition or functional problem is the device intended to address?
• What alternatives—such as footwear changes, exercises or a less costly insert—are reasonable?
• How will fit, comfort and benefit be reviewed?
• What is the total price, return policy and any follow-up fee?
• Will your private insurer require a prescription, referral or specific provider?

Ask for the recommendation and coverage requirements in writing before paying. An advertisement or a “free assessment” does not guarantee that a product is medically needed or reimbursed.

Public coverage is limited and program-specific

If pain is severe, worsening, follows an injury or affects your ability to walk, seek timely clinical advice. This guide cannot diagnose the cause of foot pain.

Sources and limits

Coverage is limited to program criteria; a health professional should assess symptoms and individual needs.

General information based on federal and national rules; provincial rules may differ. Confirm with the official body before acting.