When Would You Prescribe a Prefab Over a Custom Orthotic?

Custom orthotics remain the gold standard for patients who need tailored bio-mechanical correction. But in the real world of clinical decision-making, there are many scenarios where a prefabricated (prefab) orthotic is not only sufficient—it’s often the smarter, most efficient choice.

Rather than viewing prefab orthotics as a “lesser” option, think of them as a powerful tool in your treatment arsenal: versatile, effective, and appropriate for a wide range of clinical presentations. Below are five key situations where a prefab orthotic may be the best solution.

1. Use Prefabs While Waiting for a Custom Orthotic to Arrive

Even in the fastest labs, custom orthotics take time. If a patient is in pain or showing functional limitations, you don’t want them waiting several weeks without support.

Why prescribe a prefab here? A high-quality prefab orthotic can offer immediate relief by stabilizing the foot, controlling pronation or supination, and helping prevent further strain. It’s a temporary solution—but not a throwaway one. In fact, some patients report significant benefit from this interim step, which can buy time for tissue healing and keep them moving during the fabrication process.

Bottom line: It’s better to provide something helpful now than to let a patient go unsupported while they wait.

2. Multiple Pairs for Different Footwear

One of the most common patient questions after receiving a custom orthotic is: “Can I get a second pair?” And while custom pairs for every shoe type would be ideal, the cost can quickly add up—especially for patients who alternate between many different shoes and styles.

Why prescribe a prefab here? Prefabs are an economical and convenient way to extend orthotic benefits across multiple shoe types. For shoes with limited volume or unique shaping (e.g., cleats or flats), a slim-profile prefab can often fit better than a full-length custom anyway. You’re giving the patient the flexibility they need without compromising core support.

Bottom line: Prefabs expand your treatment beyond a single shoe, increasing compliance and patient satisfaction.

3. For Children Who Are Still Growing

Prescribing custom orthotics for a child whose foot size or biomechanics will change in 6 months can be a tough sell—both medically and financially. While there are cases where a pediatric custom device is warranted (e.g., for neuromuscular disorders or significant structural deformities), most mild-to-moderate conditions can be well-managed with prefabs.

Why prescribe a prefab here? Modern prefab orthotics offer impressive support and durability at a fraction of the cost, making them ideal for managing pediatric flatfoot, mild pronation, or heel pain. You can reassess and adjust the prescription as the child grows without the pressure of high replacement costs.

Bottom line: Prefabs keep pediatric care practical, affordable, and responsive to change.

4. Budget or Insurance Limitations

Not every patient has coverage for custom orthotics, and even with insurance, out-of-pocket costs can be a barrier to care. When price becomes a deciding factor, the risk is that the patient declines treatment altogether.

Why prescribe a prefab here? You can still deliver measurable improvement and long-term value with a well-made prefab device. Many prefabs use medical-grade materials and offer features like deep heel cups, semi-rigid shells, or met pads—allowing you to address common pathologies like plantar fasciitis, overpronation, and metatarsalgia effectively.

Bottom line: If a patient can’t afford a custom orthotic, a prefab keeps them in the game—and builds trust that may lead to a custom down the road.

5. Trial or Diagnostic Use Before Going Custom

Some patients are orthotic first-timers. Others have complicated biomechanical issues and aren’t sure if a device will help—or how much control they’ll tolerate. In both cases, a prefab can act as a valuable trial tool.

Why prescribe a prefab here? Using a prefab orthotic gives you a low-risk way to assess how the patient responds to orthotic intervention. Does their pain improve with neutral alignment? Do they tolerate arch support? Are further accommodations needed? You can use their feedback to fine-tune the eventual custom prescription.

Bottom line: Think of the prefab as a diagnostic lens—it reveals how a patient interacts with structural change before making it permanent.

Final Thoughts: It’s Not Either/Or—It’s When and Why

Prescribing prefabs doesn’t mean lowering your clinical standards. It means applying the right solution at the right time for the right patient. When used strategically, prefabricated orthotics can enhance outcomes, support patient adherence, and make foot care more accessible.

Custom orthotics are still the ultimate answer for long-term control and personalized care. But prefabs? They’re often the perfect first step.

Start prescribing top-quality prefab orthotics with a JM Starter Pack—get yours today! Designed with your practice in mind, our prefabs provide fast, reliable relief for your patients while giving you a simple, professional solution you can confidently offer right out of the box.