Living with back pain resulting from an injury, overuse, or surgery can be debilitating. Spinal orthoses are orthopedic appliances that support, align, prevent, or correct deformities. These orthoses address musculoskeletal problems resulting from trauma or disease.
Our team creates innovative orthoses that allow our patients to maintain an active and productive lifestyle. Our on-site laboratory allows us to create and customize devices within days.
Listed below are our upper extremity services and devices. If you want to request more information or schedule an
appointment, please contact our office.
Pedorthics involves the management and treatment of foot and ankle conditions caused by disease, congenital defect, overuse, and injury. Our orthotic therapy offers research-based custom foot orthoses.
Listed below are our pedorthic services and devices. If you wish to schedule an appointment or ask for more information, please contact our office.
Living with physical challenges can be overwhelming, frustrating, and disheartening. Orthotics offer an alternative for a more active and enriching life. Our orthotist specializes in lower extremity orthotics providing you with options for a more active style.
Lower extremity orthoses are external braces and supports that are designed to improve function by controlling motion, provide stabilizing support, reduce pain by transferring the load to another area, correct flexible deformities, and prevent progression of fixed deformities.
We offer a scientific approach with all our custom orthoses, integrating research-based orthotic therapy. Our on-site laboratory allows us to create and customize devices within days.
Listed below are our lower extremity services and devices. If you want
to request further information or schedule an appointment, please contact our
Diabetes affects over 29 million people in the United States. Foot problems are a common complication in people with diabetes. Our Foot Care Wellness Program is an extensive approach to maintaining the health of your feet. Your physician and orthotist at BT Orthotic Labs, Inc. will design a treatment plan to meet your needs.
Diabetic peripheral neuropathy refers to nerve damage that affects the arms, hands, legs, and feet. People with diabetes often develop nerve damage that can lessen their ability to feel pain, heat, and cold.
Our goal at BT Orthotic Labs, Inc. in Farmingdale, New York is to prevent, protect and maintain healthy foot care for our patients with diabetes. Through education and together with your physician and our orthotist, we can design a treatment plan that best meets your needs. An integral component to our success is our follow-up program.
Listed below are our Diabetic
Foot Care Wellness Program services and devices. If you wish to ask for more
information or schedule an appointment, please contact our office.
Living with an amputation can be overwhelming and frustrating, as it can have a profound impact on your life. The implications of a physical change in your body will alter how you live your life. We at BT Orthotic Labs, Inc. provide our patients with the benefit of technology and clinically proven prosthesis for all levels of activity.
There are different interventions used to manage partially amputated feet. These options vary upon the type of amputation, function, cosmetic considerations, and activity level. The criteria of any prosthesis are to restore normal foot biomechanics, distribute plantar weight, improve balance, and properly transfer energy.
Listed below are our prosthetic services and devices. If you want to schedule an appointment or request further information, please contact our office.
New patient forms can be downloaded from our website and completed prior to your appointment.
If you choose to fill these forms out at our office, please arrive at least 15 minutes prior to your scheduled appointment.
Please make sure you bring the following:
Your first appointment will consist of a thorough examination and evaluation by our BOC-certified orthotist. Depending on the complexity of your condition, your office visit could last anywhere between 20 minutes to an hour. Your practitioner will review your options and recommend an appropriate device that suits your needs and lifestyle. We recommend that you bring any previously worn devices and footwear if applicable.
To help expedite the form filling process, we recommend filling out the standard paperwork prior to your visit. To do so, just print the forms below. Review the forms to ensure all information is accurate and bring them to your appointment with you.
If you have any questions, please call us. We are here to help.
For further information regarding accepted insurances, kindly contact our billing manager, Melissa Irizarry, at 631-470-3778.
"A tiny change today brings a dramatically different tomorrow."
- Richard Bach
The use of an orthotic, whether short- or long-term, changes our lives. This affects us emotionally and changes how we live our lives on a daily basis. Preparing our patients for these changes and how it can improve their quality of life is our aspiration.
Your new orthoses are fabricated specifically for you. They have been constructed of materials to meet your level of activity. The device is designed to provide maximum comfort and appropriate biomechanical control to address your specific needs.
Our orthotist will furnish you with a Care and Wear Guide pamphlet for your device.
During your fitting/delivery appointment, the orthotist may have indicated some specific requirements unique to your condition. These alterations in your position may feel unusual at first. However, you should fully adjust to your new posture within a few days.
Your physician will give specific instructions as to your particular protocol, but normally the orthosis is to be worn when active and ambulating. There is no break-in period for post-operative or fracture management uses of AFOs and KAFOs.
If non-ambulatory, the AFO can be used to prevent ankle contractures and keep the ankle and foot in a proper position (if applicable).
Your physician will give specific instructions as to your particular protocol, but normally the orthosis is to be worn when active and ambulating. There is no break-in period for post-operative or fracture management uses of KAFOs.
"I have not been handicapped by my condition. I am physically challenged and differently able."
- Janet Barnes
Maria contracted poliomyelitis when she was four years old. She has undergone multiple surgeries that were performed to stabilize both feet and ankles and fuse her hip and knee.
We were able to fit Maria with a HKAFOs (Hip-Knee-Ankle-Foot Orthoses) and custom molded shoes. These orthoses enabled Maria to regain her independence and maintain an active lifestyle.
Bilateral Partial Foot Amputee
Francesca is an avid athlete and participates in college-level soccer. We fabricated a custom leather gauntlet with a toe filler, which fit into her massive collection of boots and shoes!
Drop Foot Patient
Joseph was diagnosed with Compartment Syndrome due to a football injury. As a result, he developed Drop Foot which left him unable to participate in sports and affected his mobility on a daily basis. We fit him with a streamlined Composite AFO which greatly improved his level of activity.
section includes orthosis terminology and a glossary of injuries, diseases, and
Orthoses are named according to what bones, joints, or portions of the body they encompass.
Ankylosing Spondylitis: Ankylosing spondylitis involves inflammation surrounding one or more of the vertebrae. It is a chronic inflammatory disease that affects the joints between the vertebrae, eventually causing them to fuse or grow together.
Patients exhibit a “stooped” posture and have a very rigid spinal column. Surgery, if indicated, can be very dangerous, due to the rigidity of the spine and the repositioning. There can be significant nerve damage.
Cerebral Palsy (CP): Cerebral palsy is a term used to describe a group of disorders that affect movement control. It can be caused by injury to the brain before, during, or after birth. Cerebral palsy may be acquired after birth secondary to an accident, head injury, or infections such as bacterial meningitis or viral encephalitis. Symptoms vary with each case.
Degenerative Joint Disease (DJD): DJD is also referred to as osteoarthritis (OA). It may affect over 80% of people over the age of 60. Arthritis is a general term used for many conditions that result from the degenerative changes of the joint and its structures. DJD describes a slow and progressive loss of the cartilage structures that function as a shock absorber between two bones.
Cartilage helps to provide a barrier and helps keep the joints flexible. Once the cartilage is thinned or lost, the constant grinding of bones against each other causes pain and stiffness around the joint. Abnormal and excess bone formations called spurs grow from the damaged bone, causing further pain and stiffness.
Diabetes: Diabetes is a metabolic disorder in which the body does not produce or properly utilize the insulin hormone. Our bodies digest food for growth and energy in the form of glucose (sugar in the blood). Glucose is the main source of fuel for the body.
After digestion, the glucose passes into the bloodstream where it is used by the cells for growth and energy; transportation is accomplished by insulin, a hormone produced in the pancreas. The amount of insulin produced by our body is regulated by what we eat.
Patients that suffer from diabetes produce too little insulin and therefore cannot process the glucose properly. When this occurs, glucose overflows into urine and is passed out of the body. This translates into a decrease of fuel for the body.
This disease is categorized as Type I or Type II and has a significant effect on other systems and can lead to cerebrovascular and coronary artery complications, peripheral vascular impairment; visual impairment; and peripheral and autonomic nervous system impairments.
To prevent ulcerations, skin breakdown, and abrasions, patients are observed carefully for signs and symptoms of diabetic neuropathy, such as numbness or pain in the hands and feet, decreased vibratory sense, foot drop, and neurogenic bladder.
Multiple Sclerosis: MS is an autoimmune disease of the central nervous system (CNS). It presents with the destruction of myelin (outer sheath of the nerve cells) and nerve axons within several regions of the brain and spinal cord at different times.
This destruction results in temporary, repetitive, or sustained disruptions in nerve impulse conduction causing symptoms such as muscular weakness, numbness, visual disturbances, or loss of control of bowel, bladder, and sexual functions. MS is a relatively common disorder: 250,000 + Americans are affected multiple sclerosis. Women are twice as likely to be diagnosed as men.
Muscular Dystrophy Syndrome: Muscular dystrophy (MD) is a genetic syndrome that causes muscle weakness and wasting. MD is a progressive disorder that affects the lower extremities and gradually moves more proximal. As it moves proximal, it may affect cardiac and respiratory systems. This condition is found more in males than in females.
Myelomeningocele and Spina Bifida: Myelomeningocele and spina bifida patients present with a portion of the spinal cord and membranes protruding from their backs. These patients experience paralysis at the level of spinal cord destruction. Depending on the level of disruption, patients can require limited orthotic intervention. It can even be as involved as reciprocating gait orthoses and wheelchairs.
Neurofibromatosis: Neurofibromatosis is a disorder characterized by the formation of neurofibromas or tumors that involve nerve tissue in the skin, subcutaneous tissue, cranial nerves, and spinal nerve roots. It presents with visible skin tumors, café au lait spots, and pain surrounding the nerves involved.
Peroneal Palsy: This is a condition caused by an injury or damage to the peroneal nerve. Patients often present with drop foot, weakened dorsi flexors, and evertors (those muscles innervated by the peroneal nerve).
Rheumatoid Arthritis: This is characterized as a chronic inflammatory disease that primarily affects the joints and surrounding tissues. This is often associated with severe joint swelling, pain, and fatigue.
Spastic Hemiplegia: Spastic Hemiplegia involves increased muscular tone occurring in half
of the body. It results from an upper motor
neuron lesion, such as a stroke, central nervous system trauma, or
Lymphedema: Lymphedema refers to the abnormal accumulation of tissue or lymph fluid in the interstitial spaces.
Pitting Edema: Pitting Edema is a local or generalized condition in which the body tissues contain an excessive amount of tissue fluid. If you apply slight pressure to the area of edema and then remove the pressure, you will see a resultant indentation. The indentation will then resolve after the pressure has been removed and the fluid migrates back to its original state.
Fracture Classifications Axial Compression Fracture/Burst Fracture: A burst fracture refers to the disruption of the integrity of the vertebral body. It is characterized by the inability of the vertebral body to resist axial loading. These fractures are mechanically unstable, and if bony fragments are retro-pulsed (moved backward) into the spinal canal, they can be neurologically unstable.
Closed Fracture: A closed fracture is a broken bone without an open wound.
Comminuted Fracture: A comminuted fracture is a bone that is splintered or crushed.
Displaced Fracture: A displaced fracture is a broken bone with the parts of the bone misaligned.
Dislocation Fracture: This injury is a combination of a dislocation of the joint and a fracture (usually located very close to the joint).
Malunion: Malunion refers to the healing of the bone in an unsatisfactory position.
Nonunion: Nonunion refers to the permanent failure of the bone to heal together (pseudo-joint).
Immobilization of Injured Area: It is also imperative that the fracture site is immobilized while the bones are allowed to heal together in proper alignment. If motion is allowed at the onset of the rehabilitation process, there is a high incidence of malunion and/or poor reduction/alignment.
Reduction: This refers back to immobilization. The objective of a fracture orthosis is to maintain compression of
the limb to, in effect, maintain the alignment of the fracture.
Achilles Tendonitis: Achilles tendonitis causes inflammation and degeneration of the Achilles tendon.
Ankle Instability: Ligamentous instabilities of the ankle are often a result of ligamentous laxity, acute or chronic ankle injuries including sprains and or strains.
Bunion: A bunion is a thickening of the first metatarsal joint of the great toe. This is usually associated with enlargement and lateral displacement of the toe. Heredity, degenerative bone, or joint diseases such as arthritis may cause bunions. However, ill-fitting shoes are the primary causes of this condition. High heels force the toes together and displace weight onto the forefoot.
Cavus Foot Deformities: This is characterized by an abnormally high longitudinal arch or concavity of the sole of the foot. This condition causes excessive pressure on the calcaneus (heel) and the metatarsal head (forefoot). Orthotics often helps to redistribute pressure and help prevent skin breakdown and abrasions.
Charcot Marie Tooth: Charcot-Marie-Tooth disease (CMT) is a disorder of nerve conduction causing weakness and mild loss of sensation in the limbs. These patients often present with rigid cavus deformities of their foot and ankle.
Club Foot (Talipes Equino Varus): This term is derived from Latin (talipes = anklebone, pes = foot, equino = horse). The term "clubfoot" refers to a foot that points downward; the toes turn inward, and the bottom of the foot faces inward. If this condition occurs when a baby is born, it is called "congenital clubfoot."
If left untreated, the condition can worsen causing the patient to walk on the dorsum of their foot. Serial casting, corrective surgical procedures, and orthosis are often used to treat this condition.
Flat Foot (Pes Planus): This refers to the abnormal flatness of the sole and the arch of the foot. Most of the time, this condition is asymptomatic and does not interfere with the normal functioning of the foot. The inner longitudinal and anterior transverse metatarsal arches may be depressed causing pain and discomfort. This condition may be acute, sub-acute, or chronic, and patients may benefit from orthotic intervention.
Forefoot Adduction/Abduction: Metatarsus Adductus: Metatarsus adductus is a condition in which there is medial displacement of the metatarsals. The forefoot is therefore adducted at the tarsal-metatarsal joint.
Hallux Varus/Valgus: This refers to the displacement of the big toe away/towards the other.
Hammer Toes or contracted toe is a deformity of the proximal interphalangeal joint of the second, third, and/or fourth toes. The deformity causes the toes to be permanently bent, resembling a hammer.
Hallux Rigidus: This is a form of degenerative arthritis and stiffness that affects the MTP joint at the base of the hallux (big toe).
Metatarsalgia: Metatarsalgia is a condition characterized by pain emanating from the metatarsal heads; this pain increases with weight bearing and pressure. Shoes with higher heels that place the majority of the weight on the forefoot and metatarsals often worsen this condition.
Morton's Neuroma: This refers to an injury to the nerve between the toes, causing thickening and pain. It commonly affects the nerve that travels between the second and third or third and fourth toes. The symptoms include tingling in the space between the toes, toe cramping, and sharp, shooting or burning in the ball of your foot.
Osteochondral Defect (OCD): This condition is associated with deep trauma to the talus. The cartilage and bone have been disrupted causing a crater or deep defect on the surface of the joint.
Plantar Fasciitis: This condition is an inflammation of the plantar fascia (fibrous connective tissue that runs along the bottom plantar surface) of the foot from the heel to the metatarsal region. This commonly occurs in athletes and is caused by a strain/over-stretching of the fascia. This causes pain, inflammation, and often a bone spur at the attachment site on the calcaneus.
Posterior Tibial Tendonitis: This is the inflammation of the posterior tibial tendon and its sheath that affects the tendon as it runs from the medial aspect of the ankle to the medial arch of the foot. The posterior tibial tendon helps maintain the arch of the foot, inverts the foot, and helps the plantar flexion. Injury to this tendon may result in loss of function, primarily affecting push off from the ground during walking and running.
Insufficiency (Posterior Tibial Dysfunction): Progressive failure of the posterior tibial tendon, associated with failure of the ligaments and joints in the medial side of the ankle and
foot. This results in the collapse of the
medial arch of the foot, forefoot abduction that most often becomes
debilitating in its later stages.
Bone Remodeling: Bone is dynamic,
and it is continuously remodeling in response to mechanical forces and
metabolic demands. Stress, pressure, weight bearing,
and physical activity increase and help control the remodeling process.
Range of Motion: It is important to mobilize the affected area after the initial healing process has begun. This helps to prevent contractures, maintain muscle strength, and promote bone growth.
Sprain: This refers to the trauma to a ligament that causes pain and at times, disability, depending on the severity of the injury to the structure.
Strain: This refers to trauma to a muscle or the musculotendinous unit by way of a violent contraction or excessive forcible stretch.
Facet Syndrome: Facet syndrome is usually difficult to diagnose. It presents
with localized low back pain usually on one side and near/around the joint capsule.
In some cases, there may be degenerative changes
on the facet surfaces causing further irritation.
Herniated Disc: A disc herniation refers to a derangement of the intervertebral disc. In this instance, the nucleus pulposus is pushed out through the outer annulus fibrosus applying pressure to the spinal column. Pain can result from inflamed tissue and from nerve compression.
Most disc herniations are posterior (out the back) and to the side. In some severe cases, there can be nerve root compression causing radicular pain and lower extremity weakness.
Low Back Pain: The term “non-specific low back pain” refers to a condition where there is a localized pain in the back but no specified origin found. Pain is often referred to as a dull, continuous pain with tenderness near the muscular attachment sites of the lower lumbar, lumbosacral, and sacroiliac vertebral segments.
Scoliosis: Scoliosis is defined as an abnormal bending of the spine. It is often thought of as a lateral bending. However, rotational, flexion, and extension abnormalities are also exhibited. Oftentimes, we associate scoliosis with juveniles however if left untreated adult and geriatric patients can have severe secondary complications such as spinal nerve root compression, pain, and pulmonary complications.
Trauma: Trauma to the spine can involve a fracture, spinal cord injury, nerve
compression, and syndromes such as central cord
syndrome and Brown-Sequard syndrome.
Brachial Plexus Injury, also called Erb’s Palsy or “Waiter’s tip,” is an injury to the brachial plexus resulting in weakness or paralysis of the upper extremity. The patient often has an arm that hangs limp and is internally rotated at the shoulder. The elbow is extended, but the flexion of the wrist and fingers are preserved with the palm potentially facing up.
This injury is common with difficult births (2-3 per 1000 births) symptoms will sometimes resolve with immobilization, however, if no improvement is seen, surgery is indicated.
Carpal Tunnel Syndrome, characterized by pain, numbness, or tingling in the wrist, is typically associated with repetitive motions of the hand. The repetitive motions cause swelling and compression of the median nerve and tendons that pass through a tunnel of fibers at the base of the hand causing the symptoms listed above.
Fracture Management and Orthotic Intervention Protection of the injured area: Once the fracture has been reduced (realigned), it is imperative that it is protected from further detrimental forces.
Epicondylitis is an inflammation or damage to the area of an epicondyle of bone. An epicondyle is a projection of bone above condyle (a rounded prominence at the end of a bone usually where the bone connects to another bone) where ligament and tendons are attached.
Golfer’s Elbow, also called Medial Epicondylitis is indicated by increased pain over the inner or medial side of the elbow. It is often a result of small tears in the flexor tendons that attach at the elbow. Common symptoms include pain on the inside of the elbow, pain when lifting, or pain when flexing and supinating (turning your palm upward).
Stenosis: This refers to a narrowing of the intervertebral foramen from which the spinal nerves exit. This occurs due to degenerative changes that cause a bony overgrowth in the canals. Symptoms resulting from nerve impingement include associated back pain and radiating pain down both legs.
Patients report some relief when sitting or when the spine is flexed creating a wider opening for the nerves to pass through. Surgery is sometimes indicated to “open up the canals” creating a larger passage or foramen decreasing nerve root compression.
Tennis Elbow, also called Lateral Epicondylitis, is usually indicated by increased pain over the lateral portion of the elbow. It is often a result of small tears in the extensor tendons that attach at the elbow. Common symptoms include pain on the outside of the elbow, pain when lifting something, pain when extending and pronating (turning your palm downward).
Ulnar is the larger of the two large bones in the forearm and is located on the same side of the arm as the little finger.