Evidence-Based Guidance for Heel Pain – Not Sales Talk.

When people first develop heel pain, one of the most common pieces of advice they hear is: “Get some insoles — they’ll fix it.”

But do orthotics really work? And if so, who actually benefits from them?

This article looks at what the clinical research says about orthotics for plantar heel pain (also known as plantar fasciitis) and explains how they may fit into a broader recovery plan.

What Orthotics Can Do — According to the Evidence

• Reduce strain on the plantar fascia
  Insoles can help to offload stress on the arch, particularly in people with flat feet or excessive pronation.
• Provide short-term relief
  Multiple studies show that orthotics can improve symptoms in the short to medium term (up to 3 months), especially when used alongside other treatments.
• Improve comfort during standing/walking
  For people on their feet all day, even off-the-shelf insoles can make walking and standing more comfortable, reducing end-of-day pain.

What Orthotics Don’t Do

• They don’t fix plantar heel pain long-term.
  Orthotics reduce load, but they don’t address the underlying issues such as tight calves, weak foot muscles, or poor gait patterns. Once you stop using them, symptoms often return unless these other problems are addressed.
• They don’t work for everyone.
  Research shows that while many people benefit, others see little or no difference.
• Custom isn’t always better.
  A 2008 randomised trial found no significant difference between custom orthotics and off-the-shelf insoles in reducing heel pain.

So… Should You Use Them?

A good rule of thumb: orthotics may be worth trying if you:

• Have flat feet or very high arches
• Spend long hours standing or walking on hard surfaces
• Wear non-supportive footwear
• Are in the more painful, early stage of plantar heel pain

But remember — they should be seen as part of a full treatment plan, not a stand-alone solution.

Choosing the Right Orthotics

• Over-the-counter insoles — First step: affordable, widely available.
• Semi-custom / heat-moulded insoles — Mid-range option: better fit and support.
• Fully custom orthotics — Higher cost; worth considering if pain is severe, persistent, or you’ve already tried other options.

Whatever type you choose, make sure your shoes fit the insoles correctly — otherwise, even the best orthotics won’t help.

Bottom Line

Orthotics aren’t a cure — they’re a tool.

They can reduce pain, improve comfort, and support healing in the short term, but long-term recovery depends on addressing the root causes.

The best outcomes come when orthotics are combined with:

• Daily stretching (especially calves and fascia)
• Strength work for the foot and lower leg
• Gradual return to walking or sport
• Professionally guided support if needed