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By altering the heel height custom orthoses can also be used to correct or reduce short leg or what is known as a leg length inequality. Though many stores offer over-the-counter orthopedic shoes, orthotic inserts and heel lifts, these are not custom designed, which means they are ineffective for an individual with an abnormal spinal curvature.
Orthopedic shoes and foot orthotics can be just one aspect of a comprehensive program of treatment for an individual with scoliosis or for those at risk of developing scoliosis. A wedge inserted into the inner (medial) side of the sole of a shoe can be used to help support a flatfoot, thus reducing the risk of tendinitis. Doctors sometimes prescribe specialized shoes and orthotic shoe inserts for people with scoliosis.
An ankle-foot brace can help relieve the pain of rheumatoid arthritis in the heel or ankle.

Unlike generic, over-the-counter orthotics, Stabilizing Orthotics are individually designed for unique postural problems — not just problems with your feet. Orthopedic shoes and custom foot orthotics may prevent further progression of certain types of scoliosis in children with asymmetrical legs and reduce back pain in adults with scoliosis.
Orthotics can also reduce scoliosis hip pain, scoliosis back pain, and other scoliosis back problems associated with adult scoliosis, if the pain can be attributed to a secondary orthopedic issue. However, if one leg is shorter because the foot has poor arch development or because the child places excess weight on the inside of one sole, they may require a custom orthotic to support the foot in the areas around the arch. However, according to an article in The New York Times Health Guide, whether heel lifts can reduce existing spine curvature is still to be determined.
Heel cushions can help absorb impact and relieve stress on the heel and ankle when you walk or run.

If the leg is functionally rather than anatomically shorter, the scoliosis may worsen if a heel lift is used rather than an orthotic shoe insert. More research remains to be done to clarify the use and appropriation of orthotics in scoliosis. The heel counter should either be straighter or curved, depending on your particular foot type. By taking an X-ray with the orthotic in place, it can be determined how the orthotic is effecting the scoliotic spine.

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