Osteoarthritis (OA) is also known as degenerative joint disease. It is the most common type of arthritis. It occurs when the cartilage at the joint surface breaks down and the underlying bone becomes damaged.


Symptoms include pain and stiffness. Crepitus can be present; this is a grating or grinding sensation as the joint moves through its normal range. Swelling may also occur.  Symptoms vary from person to person and some people report their symptoms to worsen with damp weather and/or activity. These symptoms result in restricted mobility and can lead to the muscles surrounding the joint becoming weaker, reducing the stability of the joint.


Tests and Diagnosis

OA can be diagnosed by a physical examination. MRI scans or x-rays can also be used to determine the specific degeneration at a joint.

Treatment for OA varies depending on the severity of the joint degeneration and the pain this is causing. Mild OA can be managed with painkillers, physiotherapy, and steroid injections.

Arthroscopic surgery may be indicated to wash out a joint and remove loose fragments of bone that cause a joint to lock.

If a joint has severely degenerated, joint replacement surgery will be indicated. In the UK, hip and knee replacements are the most common types of joint replacement surgery.

Orthotic Treatments

Orthotic treatment may be used at any stage of osteoarthritic disease.

Foot orthotics are used to provide stability, support and to slow the progression of the disease at the bones of the mid and forefoot or ankle. They can also be used to influence the ground reaction forces acting at the knee and hip. This can be an effective treatment in the early stages of OA at these joints.

In more severe cases of OA in the foot and ankle, orthotic footwear and insoles can be used to offload painful joints and accommodate severe joint deformity.

Hinged SMOs (supra malleolar orthoses) are lightweight, neat plastic ankle braces. They can be used in severe OA at the ankle where there has been the collapse of the joints. These provide stability and relieve pain to allow for continued mobility.

Knee braces can be a very effective way of treating unilateral compartmental OA at the knee. This type of bracing offloads the compartment of the knee that is degenerating, reducing pain and progression of the disease. It is also an alternative treatment in severe OA when surgery is not indicated. Research and development has moved forward in recent years with knee bracing for this condition and it is now recognised as a very effective form of treatment.

Each case of OA presents itself very differently in terms of the symptoms and the biomechanical deficits the joint disease is causing. At LOC, we provide a detailed orthotic assessment and have vast experience in prescribing effective orthotic treatment for this painful condition.

We now have the advantage of using our Gait Lab facilities to test and provide objective measurements of the effectiveness of joint offloading orthotics.

Above: SMO

Above: SMO


We have the following facilities and amenities at our Kingston Upon Thames location:

  • Free parking
  • Wheelchair ramp
  • Disabled toilet
  • Baby changing facilities

We also have the Gait Laboratory for orthotics patients and Onsite Manufacturing for speedy turnarounds and adjustments whilst you wait.

We have the following facilities and amenities at our Cambridge location:

  • Free parking directly outside the clinic
  • Large Waiting Room
  • No Toys (Due to Health & Safety Requirements of the clinic)
  • Baby changing space (In clinic room)

For more information about The Beechwood Complementary Medical Practice, please visit The Beechwood Practice.

We have the following facilities and amenities at our Bristol location:

  • Free parking directly outside the clinic
  • Large Waiting Room
  • Free tea, coffee and water
  • No Toys (Due to Health & Safety Requirements of the clinic)
  • Baby changing space (In clinic room)
  • Fully wheelchair accessible
  • Short walk to Clifton Village centre for shops, restaurants & cafes

For more information, visit Litfield House Medical Centre.

LOC’s clinic is based in the University of Salford’s Podiatry Department and provides treatments for orthotics, scoliosis, pectus deformities, positional plagiocephaly and club foot.

It is also the base for LOC’s northern OSKAR clinic which is run by Sam Walmsley, clinical director of LOC, in conjunction with Elaine Owen MBE MSc SRP MCSP.

Due to COVID-19, we have had to temporarily close the Salford clinic and are operating out of another clinic in Bolton. 

508 Blackburn Rd,

Astley Bridge,




For more information, please visit The Good Health Centre 

An insole is a contoured orthotic device which alters the characteristics and biomechanics of the foot and ankle area. Biomechanics are concerned with mechanical laws and how they affect the living body, especially the musculoskeletal system.

They are removable devices, often made from plastic, that are designed to fit inside a shoe to provide additional support for your feet. As well as offering shock absorption, an insole can help distribute the weight of your body more effectively across the foot and can be made bespoke to cover a range of biomechanical conditions.

If you have symptoms in your feet, ankles, hips or your lower back that are intermittent or were not there to start with in early life, and have started to cause you pain over a period of time, bespoke orthotic insoles could be an excellent option.

If you have already tried rest, icing, compression and elevation and your feet have not recovered, we recommend a biomechanical assessment to consider the possibility of insoles. They are a non-invasive approach to treatment and in many cases, are a great option for symptoms that are not severe enough to warrant surgical intervention. Alternatively, they can be considered as an option prior to surgery.

We will send patients away when an insole is not appropriate, if a patient is suffering with iliotibial band syndrome for example, the problem can be helped with physiotherapy and a stretching programme. That’s what our biomechanical assessment is all about; determining whether there would be any benefit from altering the alignment of your feet.