Custom Orthotics or Over The Counter Orthotics. What’s The Difference? Patients often ask what the real difference is between an over the counter orthotic and a custom orthotic.  The answer is very simple.  Over the counter orthotics are symmetrical and therefore will only work for a small percentage of the population.  Custom orthotics are molded and created just for your feet and gait.  In some circumstances, it’s necessary for one orthotic to be different than the other.  This is impossible to accomplish with over the counter orthotics but can make a huge difference for a patient suffering with foot pain.  If you have questions about orthotics and would like to speak with an experienced podiatrist in the Austin, Texas area, give Dr. Craig H. Thomajan DPM, FACFAS a call at 512-328-8900.