Orthotics and splint assessment (Orthotics and splinting assessment)
An assessment by an orthotist or therapist to work out whether a brace, splint, insole or other supportive device would help you, and to design and fit one to your body and your goals.
✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review
In short
- The assessment matches the right device to your body and goals; it is not about selling you a brace.
- An orthosis supports or protects a part of the body — it usually helps function and comfort rather than curing the underlying problem.
- Orthotic services are widely available on the NHS when a device is clinically needed; you should not assume you must pay privately.
- Fit and follow-up matter: a poorly fitting splint can cause sores or be abandoned, so review and adjustment are part of good care.
A plain-English summary. The detail — including risks and recovery — is below.
At a glance
A general guide. Your specialist will give you advice for your situation.
Can reduce pain and improve comfort
Cases where the underlying problem needs urgent medical or surgical treatment rather than a support.
You agree a plan and, if a device is needed, what type. Simple devices may be fitted on the day; custom ones are ordered.
Clear instructions on how and how long to wear the device.
You agree a plan and, if a device is needed, what type. Simple devices may be fitted on the day; custom ones are...
The device is fitted and adjusted. You are shown how to put it on and off, how long to wear it, and how to spot...
You build up wearing time as advised and watch for rubbing or pressure marks. Minor adjustments are common.
A follow-up checks that the device fits, helps and is being used correctly, and that your skin is healthy.
What is an orthotics and splinting assessment?
An orthotics and splinting assessment is an appointment to work out whether an external supportive device — called an orthosis — would help you, and if so, which one and how it should be made.
Orthoses include insoles, braces, splints, ankle and foot supports, callipers, spinal jackets, neck collars and specialist footwear. They are used to support a weak or painful part of the body, hold a joint in a better position, take pressure off an area, prevent deformity, or help you move and function more safely.
The assessment is usually done by an orthotist (a registered specialist who designs and fits orthoses) or, for some hand and wrist splints, by a physiotherapist or occupational therapist. They examine the affected area, ask what difficulties you are having, take measurements or a cast if needed, and agree realistic goals with you.
An orthosis is a tool, not a cure. It can make a real difference to comfort, safety and function, but it works best alongside the rest of your treatment — exercise, medicines or other care — and only if it fits well and is used as intended.
Types, options & approaches
There may be different ways to do this. The right approach depends on the clinical question and your circumstances.
Off-the-shelf or custom orthosis?
| Point | Off-the-shelf | Custom-made |
|---|---|---|
| Availability | Often same day | Made to order; takes longer |
| Fit | Good for many needs | Best for unusual shapes or high risk |
| Cost factors | Generally lower | Generally higher |
| Best for | Common, straightforward needs | Complex deformity, skin or pressure risk |
Neither is automatically better. The assessment decides what your situation actually needs. A custom device is not always required.
Preparing for your test
- Be ready to explain the problem — pain, weakness, instability, falls, deformity or a healing injury — and what you hope a device will help with.
- Bring the footwear you usually wear if the device goes in or affects your shoes.
- Bring any existing splint, brace or insole, and say what works and what doesn't.
- Mention diabetes, poor circulation, numbness or fragile skin, as these change the design and the need for careful fit.
- Bring a list of your conditions and medicines, and any relevant clinic letters or scan results.
- Wear or bring clothing that lets the affected area be examined easily.
- Think about your daily routine and activities so the device can be matched to real life.
What happens
At the assessment the orthotist or therapist asks about your difficulties, your medical history and your goals. They examine the affected part — looking at movement, strength, joint position, skin and how you walk or use the limb.
They then discuss the options with you, including whether a device will actually help and what type. If an orthosis is right, they take measurements, and for a custom device they may take a cast, scan or mould of the area.
Ready-made devices can sometimes be fitted on the day. Custom devices are made and you return to have them fitted and checked. Either way, the device is adjusted so it fits well, does its job and does not rub or cause sores. You are shown how to put it on, take it off, wear it and look after it.
Is this test right for me?
A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.
May not be suitable if…
- Cases where the underlying problem needs urgent medical or surgical treatment rather than a support.
- A device that would rest a joint that actually needs to move, risking stiffness or weakness.
- Skin too fragile or circulation too poor to wear a device safely without close monitoring.
- Someone who cannot put on, remove or manage the device, and has no help to do so.
Delay or rearrange if…
- There is an active skin infection, sore or wound where the device would sit.
- Swelling is changing rapidly, so a custom fit would soon be wrong.
- Important scans, diagnoses or specialist opinions are still awaited.
- Sensation or circulation problems have not yet been assessed.
Alternatives to discuss
- Physiotherapy, hand therapy or exercises to build strength and control.
- Footwear changes, walking aids or home adaptations.
- Medical treatment of the underlying condition.
- Surgery in some cases, or simply no device if it would not help.
Before you decide
Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.
What matters most to me?
Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.
What are all my options?
Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.
What would make me pause?
Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.
What happens if I do nothing today?
For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.
Benefits
- Can reduce pain and improve comfort
- Can make walking, standing or hand use safer and easier
- Can support a weak or unstable joint or limb
- Can take pressure off vulnerable skin or a healing area
- Can help prevent or slow some deformities
- Lets the device be matched to your body, footwear and goals
Risks & complications
- Rubbing, pressure marks or skin irritation if the fit is not quite right
- Taking time to get used to wearing the device
- Needing the device adjusted more than once
- Finding it bulky, hot or awkward with some clothing or footwear
- Skin breakdown or sores, especially if skin is fragile or sensation is reduced
- The device not helping as hoped, needing a rethink
- Stiffness or weakness if a joint is rested for too long without advice
- Difficulty putting the device on or off without help
- Serious skin or pressure injury if a poorly fitting device is worn despite problems
- Worsening of a problem if the wrong device is used
- A reaction to the materials used
Most problems come down to fit and skin. If you have diabetes, poor circulation or reduced sensation, you may not feel a rubbing area until it has caused damage, so skin checks and prompt reporting really matter. Tell the service straight away if the device causes pain, redness that does not fade, or a sore. A device that is uncomfortable is more likely to be abandoned, so getting the fit right is part of it working at all.
Published figures to discuss
There are no meaningful single 'success' or complication percentages for an orthotics and splinting assessment, because the device, the body part and the condition vary so widely. The main risks — skin rubbing, pressure marks and devices being abandoned because they do not fit or are uncomfortable — depend on fit, the person's skin and sensation, and follow-up, not on a fixed figure. We therefore describe risks in plain words rather than quoting numbers.
| Figure | Reported range | How to interpret it | Source / confidence |
|---|---|---|---|
| Skin pressure, rubbing or ulceration | Common if fit or sensation is poor | Diabetes, neuropathy, spasticity and swelling increase risk; skin checks and review are essential. | NHS England — Orthotic servicesengland.nhs.ukSource-linked context |
| Falls or altered gait | Recognised | An orthosis can change balance, footwear and walking pattern, so fitting should include functional testing. | Guide sourcesClinical context |
| Contracture or stiffness not addressed | Condition-dependent | Splints may need stretching, strengthening, botulinum toxin or therapy alongside the device. | Guide sourcesClinical context |
| Device abandoned | Common practical outcome | Comfort, appearance, ease of donning, footwear and meaningful goals affect long-term use. | Guide sourcesClinical context |
These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.
What happens afterwards
There is no operation, so 'afterwards' means getting used to the device, checking it fits and helps, and using it the way it was intended.
- A short period of getting used to the feel of the device
- Mild pressure marks that fade soon after taking it off
- Needing one or more small adjustments for comfort
- Building up wearing time gradually rather than all at once
- Some trial and error with footwear or clothing that works with the device
Aftercare
- Wear the device for the time and in the way you were advised, building up gradually if told to.
- Check your skin each time you take the device off, especially if sensation is reduced.
- Keep the device and any padding clean and dry, and follow care instructions.
- Report rubbing, redness that does not fade, sores or pain promptly rather than pushing on.
- Do any prescribed exercises so a rested joint does not become stiff or weak.
- Keep your review appointment so fit and benefit can be checked.
- Contact the service if the device breaks, stops fitting, or stops helping.
- Notes on the problem and what you want help with
- Usual footwear brought along if relevant
- Existing splint, brace or insole to compare
- List of conditions and medicines, plus relevant letters or scans
- Note of any diabetes, poor circulation or reduced sensation
- Clothing that allows easy examination of the area
- Service contact number saved
⚠ Get urgent help if…
- A new sore, blister or broken skin under or around the device
- Redness that does not fade after the device is removed
- Increasing pain, numbness, tingling or colour change in the limb
- Signs of infection — spreading redness, heat, swelling or discharge
- A device that suddenly causes pain or no longer fits
- For neck or spinal supports, new weakness, numbness or difficulty passing urine — seek urgent help
- Feeling generally unwell with a fever alongside a skin problem under the device
Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.
General guidance — it doesn't replace the specific advice your specialist gives you.
Results & realistic expectations
A good outcome is a device that fits comfortably and helps you do what you set out to do — walk more safely, ease pain, support a joint or protect healing tissue. Many people notice a difference quickly, especially with pain and stability.
An orthosis usually manages a problem rather than curing it, and it works best as part of your wider treatment. It cannot fix the underlying condition, and the right device for you may change as your situation changes. If a device is not helping or is uncomfortable, that is a reason to go back, not to give up on it silently.
Orthoses wear out with use, and children especially outgrow them, so repairs, replacements and refits are a normal part of care. Your needs may also change — for example after surgery, as a condition progresses, or as you recover — so a device that suited you once may need reviewing or changing later.
Related tests, treatments or support
Orthotic and splinting care usually works alongside physiotherapy, occupational and hand therapy, podiatry, wound and diabetic foot care, pain management and sometimes surgery. The device is one part of a plan, not a stand-alone fix.
Follow-up & long-term care
You are usually offered a review to check the fit, the benefit and your skin, and to make adjustments. After that you can return if the device wears out, stops fitting or stops helping, or if your needs change. For children and progressive conditions, regular review is especially important.
- Cleaning and basic care of the device as instructed
- Checking skin regularly for pressure marks or sores
- Adjustments and repairs as the device wears
- Replacement or refitting as you change or, for children, grow
- Review of whether the device is still the right one as your needs change
Repeat, follow-on and what comes next
- Adjustments and refits are normal, especially in the early weeks.
- Devices wear out and need repair or replacement over time.
- Children outgrow devices and need new ones regularly.
- Sometimes the first device is the wrong choice and a different approach is tried.
Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.
What good aftercare looks like
- Clear instructions on how and how long to wear the device.
- Skin-check advice tailored to your circulation and sensation.
- A review to confirm the device fits, helps and is used correctly.
- An easy route back for adjustments, repairs or replacement.
- Coordination with your physiotherapy, podiatry or medical care.
What affects the cost
Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:
- Whether your care is NHS-funded (the usual route) or private
- Whether the device is off-the-shelf or custom-made from a cast or scan
- The complexity of the device and the materials used
- The number of fittings, adjustments and reviews needed
- Repairs and replacements over time, or new devices as a child grows
- Any specialist footwear or accessories required
- Whether you are eligible for NHS provision before any private route
- What the assessment includes and who carries it out
- Whether a custom or off-the-shelf device is being provided
- How many fittings, adjustments and reviews are included
- What aftercare, repairs and replacements are covered
- What happens if the device does not fit, help, or causes skin problems
On the NHS? Orthoses are provided by NHS orthotic services when clinically needed (usually with a referral); private assessment may be used for speed or choice, but you should not assume an NHS device is unavailable to you.
You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.
Consent traps and marketing red flags
These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.
Consent traps
- Not being told a device manages rather than cures the problem.
- No discussion of alternatives such as therapy, footwear changes or surgery.
- No clear skin-check advice, especially with diabetes or reduced sensation.
- No plan for what to do if the device rubs, breaks or stops helping.
- Being sold a custom device when an off-the-shelf one would do.
Marketing red flags
- Claims that a brace or insole will cure a condition.
- Pressure to pay privately for a device the NHS would provide.
- One device promoted as right for everyone with your symptom.
- No mention of fit problems, skin risk or follow-up.
- Selling expensive custom devices without proper assessment.
Choosing a specialist safely
- Check the specialist is on the GMC Specialist Register for this area.
- Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
- You're entitled to time to consider and to have your questions answered before you agree — the specialist who looks after you should explain it, not a salesperson.
- Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
- You're entitled to your total cost in writing — including any follow-up — before you decide.
Questions to ask your medical professional
Take this to your consultation. A good specialist will welcome every one of these.
- Is a device likely to help my problem, and what exactly will it do?
- Do I need a custom device or will an off-the-shelf one work for me?
- How long and when should I wear it, and how do I look after it?
- What should I watch for on my skin, given my circulation and sensation?
- How does this fit with my exercises, footwear and the rest of my treatment?
- What do I do if it rubs, breaks, stops fitting or stops helping?
- Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
- Will you be the specialist who carries out my test, and who looks after me afterwards?
- What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
- What does a realistic result look like — and what can this test not achieve?
- What are my options, including waiting, doing nothing for now, or choosing a different approach?
- Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
- What is the total cost in writing, including any follow-ups, and how much time do I have to decide?
Frequently asked questions
Can I get a splint or brace on the NHS?
Will a device cure my problem?
How long until I get a custom device?
What if it rubs or causes a sore?
Do I have to wear it all the time?
Can I buy an off-the-shelf support instead?
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How we made this page
Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →
Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.
Sources & standards: NHS England — Orthotic services British Association of Prosthetists and Orthotists (BAPO) NHS — Foot drop Versus Arthritis — Splints for arthritis of the hand and wrist Living Made Easy (Disabled Living Foundation) Manchester University NHS — Orthotics service information
Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.
Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.
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