“It’s not entirely clear how orthotics work to cause these positive changes, but data suggests the inserts affect the foot’s very fine, or micro-, control of gait, subtly altering muscle activity and reducing stress on the lower extremity,” she says.

A Cochrane Review, a systematic analysis of a number of randomized-control trials, found gold- and silver-level evidence that custom-made orthotics reduce foot pain in people with:

  • Rheumatoid arthritis
  • Bunions
  • Painful high arches
  • Juvenile idiopathic arthritis 
  • Plantar fasciitis, or heel pain

More research needs to be done to tease out specific benefits, including how long different people need to wear orthotics before feeling improvements, Hannan says. She notes that, anecdotally, “We can tell by the prevalence of people who continue to wear orthotics months and years after filling their prescription that they feel that the inserts are helping.”

Your doctor can determine whether orthotics could be a good option for you and refer you to a podiatrist who will examine your feet, ankles and hips and evaluate your gait by observing your body in motion.

Custom inserts, which last about five years, can cost between $400 and $800 a pair, and not all insurance plans cover them. As a less-expensive option, some podiatrists may customize off-the-shelf inserts to address your specific issues.


Find out which shoe inserts and other products have earned the Arthritis Foundation’s Ease of Use Commendation.