Orthotics

Orthotics include any appliance needed by a patient because of any disability, weakness or loss of function.  Another name for them is "durable medical equipment."  Common orthotics include splints and braces for the arms or legs, canes or crutches, special shoes, back braces and neck braces.  Many insurance companies provide little or no coverage for orthotics even though they can be very expensive.

In a spine practice cervical collars (soft and hard), lumbar braces (corset or molded), wrist splints, AFO braces (for the ankle) and shoes are the most commonly used devices.

Hard cervical collars

Hard cervical collars include Philadelphia collars, Aspen collars and Miami-J Collars (shown in the image on the left) among others.  The Hard collars restrict range of motion by about 90%.  Philadelphia collars are the least expensive and Aspen collars fold flat for convenient storage.  Of the available types the Miami-J is probably the most comfortable.  These collars are in the event of trauma and are also used following neck fusion surgery.  They are preferred in our practice. 

 

Soft collars

Soft collars (like the one on the right) do not significantly reduce motion but do provide some comfort.  They are a reasonable compromise in the event of neck pain which is the result of a spraining or straining injury. 

Lumbar braces

Lumbar braces include corset type braces like the camp corset to the left or the more modern Cybertech brace to the right.  The brace is adjustable and quite comfortable.  Both can be used following lumbar fusion surgery.  They decrease movement and remind one to limit activity.  They vary in price from a few hundred to about one thousand dollars.

AFO braces

AFO braces or "ankle foot orthoses" are used in cases of weakness due to a peroneal nerve palsy or an L5 radiculopathy.  They correct a "foot drop" and prevent falls.  They need to be custom made.  They are covered by insurance when their use prevents falls.

The commonest types of shoes used for medical purposes are for diabetics.  These prevent pressure sores.  Others include supportive shoes for weaker ankles and other types of shoes that decrease the stress on the back by cushioning each step.

What are z-coil shoes?

 

Z-coil shoes provide relief from a number of conditions due to one simple principle.  Simple walking puts enormous impacts on the human body.  Each step you take while merely walking has an impact pressure of 2-3 times your normal weight.  The stress of this impact is transmitted through your knees, your back, and can exacerbate existing conditions.  Z-coil shoes remove much of that strain by absorbing the impact of each step you take.

 

What problems can z-coil shoes help with?

Though even z-coil cannot help with every possible condition, they have been know to help people suffering from:

  • Arthritis & Joint Pain - immediate and long-term relief
  • Back Pain & Sciatica - immediate and long-term relief
  • Foot Pain
    • Heel Spurs - immediate relief and quick recovery time
    • Plantar Fasciitis -- immediate relief and quick recovery time
    • Metatarsal (forefoot) Pain -- immediate relief and quick recovery time
  • Body Fatigue - immediate and long-term energy boost

Are z-coils stable?

Yes, z-coil' s are exceptionally stable.  The flexible spring can absorb surface deviations without forcing your ankle to turn.

Does insurance cover the cost of z-coil shoes?

Orthotic shoes and other medical devices are known as "durable medical goods."  They may be covered by your insurance but in California are not tax free.  For more information see the company web site at http://zcoil.com/.  The nearest dealer is César Snee in San Jose.  His web site is http://www.ez-shoes.com/.  He will come to the Fremont office to assist our practice's patients with fittings.

A recent article in Good Housekeeping (May 2005, page 90) indicated that Z-Coil shoes may be dangerous. They cite the experience of one of their readers who reportedly suffered an ankle fracture as the result of the shoes. They indicate that their own testers felt that the shoes felt “unstable.” They strongly recommend that the shoes be fitted by a trained dealer. I have personally worn these shoes for years without difficulty. I have prescribed hundreds of pairs. I have seen no injuries in my own patients. I would strongly advise each person to assess the shoes and consider the risks and benefits carefully before purchasing the shoes. Like any medical device or orthotic, they can help some conditions but have possible risks. Remember also that one can break an ankle in any shoes if one is not careful. Consider consulting a physician or podiatrist.

Go to the next chapter on alternative care.






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Last modified: 07/27/08