Overview
Orthoses are inner soles that are placed in your shoes. They work by reducing the pressure under the painful part of your heel. Therefore, it is important that the orthoses you use contour the arch of your foot.
There are different types of orthoses, and it is important that you see a health professional for advice. The two most common types of orthoses are custom-made orthoses and pre-fabricated or “off the shelf” orthoses. Custom made orthoses are made from a cast or scan of the foot, which is most commonly performed by a Podiatrist or an Orthotist. Prefabricated orthoses are made from a generic mould of the foot and can be purchased from Podiatrists, Physiotherapists or from the local pharmacy or shoe store.
There is research evidence that custom-made orthoses are effective for reducing pain. The evidence for using prefabricated orthoses is less certain. In the early stages, we would recommend that you try cheaper prefabricated orthoses that contour your arch, rather than custom made orthoses. However, it is important to speak to a health professional to determine which type of prefabricated orthosis will be most suitable for your feet and footwear as a prefabricated orthosis that does not contour the foot or fit into your shoes can be problematic.
Safety
Orthoses are a very safe treatment. Occasionally, people may experience calf pain after they first start using orthotics. This usually occurs for a short period of time while you adjust to the orthotics. Some people may also experience blisters due to rubbing in the arch. If this occurs, it is important you see a health professional as the orthotics you have may need to be adjusted.
Evidence summary
There is evidence to support the use of orthoses for plantar heel pain. Currently, there is evidence to suggest that:
- Custom-made orthoses are effective at reducing pain
- A corticosteroid injection may be better than prefabricated orthoses at 1 month
- Prefabricated orthoses may be better than a corticosteroid injection at 3 months
- Orthoses may be better than night splints
Links to Research
Whittaker GA, Munteanu SE, Menz HB, et al. Foot orthoses for plantar heel pain: a systematic review and meta-analysis. British Journal of Sports Medicine 2018;52:322-328.
Landorf KB, Keenan AM, Herbert RD. Effectiveness of foot orthoses to treat plantar fasciitis: a randomized trial. Arch Intern Med. 2006;166(12):1305-10.