Custom Orthotics in Portland & Beaverton
Real custom orthotics — cast from your actual foot, built in-office, designed for your specific mechanics. Not the off-the-shelf inserts you’ve already tried.
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What is Custom Orthotics?
Custom orthotics are medical-grade inserts built specifically for your foot’s mechanics. They’re different from the inserts you can buy at a sporting goods store, the kiosk inserts at the mall, and the store-brand orthotics sold at podiatry offices that just stock pre-made shells.
At Pearl, when we say custom, we mean it: we cast your foot, identify the specific structural and mechanical issues that are causing your symptoms, and build the orthotic to address them. The result is an orthotic that supports the parts of your foot that need support, offloads the parts that need offloading, and lets the rest move naturally.
If you’ve tried over-the-counter inserts and they didn’t work — or worked for a while and then stopped — that’s exactly why custom orthotics exist. We see this constantly: patients who spent a year cycling through pre-made inserts, finally try true custom orthotics, and their symptoms resolve.
How Pearl Treats Custom Orthotics
We treat in stages, starting with the least-invasive option that gives you relief. Most patients don’t need surgery.
In-Office Casting and Evaluation
Your custom orthotic starts with a precise cast of your foot in its corrected (neutral) position — not a foam impression you stand on at a kiosk. We combine the cast with gait analysis, footwear assessment, and a discussion of your specific symptoms and activities.
Built for Your Specific Condition
Custom orthotics for plantar fasciitis are different from custom orthotics for bunions, which are different from custom orthotics for diabetic foot care. We build the orthotic for your diagnosis, not a generic foot shape.
Functional Orthotics for Active Patients
Runners, hikers, athletes — your orthotic needs to handle force, return energy, and fit in athletic shoes. We build functional orthotics from semi-rigid materials that perform across the activities you actually do.
Accommodative Orthotics for Diabetic and Sensitive Feet
For patients with diabetes, neuropathy, or sensitive skin, orthotics need to offload pressure points without irritation. We build accommodative orthotics from softer materials and check pressure mapping to confirm the orthotic is working.
Book My Appointment
Call (503) 284-2000
What to Expect at Your First Visit
Your first visit at Pearl is a 30–45 minute appointment focused on understanding what’s actually causing your symptoms and giving you a clear, written treatment plan.
We’ll start with a thorough conversation about your history — when the pain started, what makes it worse, what you’ve already tried, and what your goals are. From there, your provider performs a clinical exam of the affected foot and the contributing structures (gait, alignment, range of motion, sensation, circulation). If imaging is needed, we have on-site digital X-ray at both Portland and Beaverton — most patients leave with imaging completed and reviewed in the same visit.
Once we have the diagnosis confirmed, we walk through your options. Conservative care first when it’s the right answer. Injectable or advanced therapies when conservative care has been exhausted. Surgical consultation only when surgery is the appropriate next step. You leave with a written plan, a clear understanding of next steps, and timing for any follow-up.
No high-pressure pitch. No selling treatments you don’t need. The goal of your first visit is for you to walk out of Pearl knowing exactly what’s wrong and exactly what we’re going to do about it.
Frequently Asked Questions
How long do custom orthotics last?
Typically 3–5 years for most patients, depending on activity level and body weight. Athletes who put significant mileage on their orthotics may replace them every 2–3 years.
How long does it take to get used to custom orthotics?
Most patients adapt within 1–2 weeks. We give you a structured break-in protocol — a few hours a day at first, building up to all-day wear. Discomfort during break-in is normal; pain isn’t, and we adjust if needed.
Will my insurance cover custom orthotics?
Coverage varies widely. Some plans cover custom orthotics fully when prescribed for a specific medical condition (diabetes, plantar fasciitis, certain deformities). Others cover a portion. Some don’t cover orthotics at all. We verify your coverage before we cast.
How much do custom orthotics cost?
Out-of-pocket cost without insurance ranges from $400–$600 per pair. With insurance coverage, your out-of-pocket may be significantly less. We provide a clear cost estimate before fabrication.
Do I need orthotics for both feet?
Almost always yes — even if only one foot has symptoms. An orthotic on one side changes the mechanics of how you walk, which can cause problems on the other side over time.
How are Pearl’s custom orthotics different from store-brand orthotics?
Store-brand orthotics are pre-made in standard shapes. Pearl’s custom orthotics are built from a cast of your specific foot, designed for your specific diagnosis. The difference is structural — and it’s why one works and the other often doesn’t.
Can I wear custom orthotics in any shoe?
We design the orthotic to fit the type of shoe you actually wear most — work shoes, athletic shoes, dress shoes. If you need orthotics for multiple shoe types, we can build accommodating versions or thinner dress orthotics.
How quickly can I get custom orthotics?
First visit: cast and evaluation. Orthotics typically arrive within 2–3 weeks for fitting. We schedule your fitting appointment when you’re cast.
Your Pearl Provider Team
The Pearl team treating custom orthotics:
- Tim Mineo, DPM — Founder & Physician-Owner. Board Certified. 15+ Years. View bio →
- Zach Egidi, DPM — Now accepting new patients (June 2026). Surgical and conservative care. View bio →
Patient Stories
“Dr. Mineo is one of the most thorough, compassionate and professional doctors I have met. He never made me feel that he was in a hurry to move on to the next patient which in turn calmed my anxiety.”
— Shana C., Pearl patient (Beaverton)
“Dr. Mineo is very upfront and gives me choices and his opinion with my options. I trust him completely and would highly recommend him.”
— P.F., Pearl patient (Beaverton)
Read all 440+ Google reviews →
Visit Us
Pearl Foot & Ankle — Portland
1827 NE 44th Ave Suite 100
Portland, OR 97213
(503) 284-2000
Mon–Fri 8am–5pm
Pearl Foot & Ankle — Beaverton
12672 NW Barnes Rd #100
Beaverton, OR 97229
(503) 284-2000
Mon–Fri 8am–5pm
Related Conditions We Treat
Ready to take the next step?
Same-week appointments available at both Portland and Beaverton.
Book My Appointment
Call (503) 284-2000
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