Both over-the-counter orthotics and custom orthotics serve a similar purpose of supporting the arch, distributing pressure evenly across the foot, and providing additional benefits. However, there are several key differences between the two.

1. Design and Fit: Over-the-counter orthotics have a generic shape that may not perfectly match the individual's foot anatomy. They are designed to fit the average foot and come in standard sizes. On the other hand, custom orthotics are specifically tailored to an individual's foot shape, providing a more precise fit and support.

2. Material and Durability: Over-the-counter orthotics are typically made of less durable materials, which means they may not last as long as custom orthotics. Custom orthotics, being made of stronger materials, tend to be more durable and can withstand longer-term use.

3. Style and Options: Over-the-counter orthotics offer limited options in terms of style and design. They usually come in a standard design that may not cater to specific foot conditions or preferences. Custom orthotics, however, offer more flexibility in terms of style, length, and design, allowing for customization based on individual needs.

4. Referral Requirement: Custom orthotics require a doctor's referral for production. If someone is considering getting custom orthotics, it is best to consult their family doctor, who can assess their condition and provide the necessary referral. On the other hand, over-the-counter orthotics can be purchased without a referral or prescription.

5. Cost: Over-the-counter orthotics are generally less expensive compared to custom orthotics. The customization process involved in creating custom orthotics makes them more costly.

When considering orthotics, it is recommended to start by consulting a family physician who can provide a referral to a local pedorthist or recommend other healthcare professionals like physiotherapists who can help with orthotic fitting.