If your feet ache after a day of walking and you’re looking for relief, you’re not alone.
In 2015 Americans spent about $4.7 billion on orthotics sold in supermarkets, drugstores, sporting goods shops, and online. The products include flat pads as well as inserts designed to support arches, stabilize heels, or take pressure off areas of the feet that hurt or are rubbed by footwear.
Custom orthotics require an evaluation by a foot expert such as a podiatrist and can cost hundreds of dollars, with insurance picking up little to none of the tab. But over-the-counter inserts often cost less than $10. Best of all, there's evidence that for some people with foot pain, they actually work.
“A $50 pair of orthotics could potentially be as effective as a $400 to $500 custom pair,” says Reed Ferber, Ph.D., director of the University of Calgary’s Running Injury Clinic.
In several studies, over-the-counter orthotics significantly eased common heel and foot pain problems that can make walking, doing chores, and generally being active problematic.
In one large review of the effectiveness of pricey podiatrist-crafted orthotics, researchers from Australia’s University of Newcastle concluded that drugstore types were just as good as expensive custom orthotics for several types of foot pain. An older University of California study found that over-the-counter inserts worked better than custom models for one type of plantar fasciitis (a common ailment in which a thick band of tissue on the bottom of the foot becomes inflamed).
And orthotics can help a wide range of people with aching feet, not just serious athletes. Foot orthotics "can be used among many different populations to effectively treat pain and improve functional capability, from children to older adults, and from the sedentary to elite-level athletes," says Daniel Bonanno, a podiatry lecturer at La Trobe University in Australia.
Who Should Consider an OTC Orthotic?
If you have diabetes or circulation problems—which can cause foot ulcers and infections—the American Podiatric Medical Association advises talking to a healthcare professional before trying out an over-the-counter orthotic. A podiatrist can find solutions for foot- and leg-pain issues that won’t rub or irritate your feet.
If you're otherwise healthy but are experiencing foot pain, experts say over-the-counter insoles can be a good option.
Just remember that they're intended to help ease foot pain, not something more complex, like back pain. “They work best for foot pain of all sorts," including ankle pain and shin pain, notes Ferber, who has studied prefabricated orthotics extensively. “But they’re less effective for knee, hip, and lower back pain. There are so many more variables involved with discomfort in those areas.”
Over-the-counter solutions may not correct underlying problems that can cause long-lasting discomfort as effectively as custom inserts. But Ferber says they can come close—with significant money and time savings for patients who don't go the custom route.
For the best results, Ferber recommends that people experiencing foot pain try calf raises in addition to using orthotics. While standing with feet shoulder-width apart, raise up on your toes for 2 seconds, then lower your feet to the ground slowly (about 2 seconds). Hold onto a countertop or sturdy chair for support. “Do 20 to 60 a day," he says. "This one exercise strengthens nine muscles that support the structure of your foot and propel you forward with every step. It can help fallen arches, heel pain, ankle pain, and shin pain.”
How to Shop for an Orthotic
Bring the shoes you plan to use with your new orthotics. Try the orthotics in them. They should feel good right away.
Zero in on your needs. If you have mild-to-moderate allover foot aches after being on your feet for a while, you may just need a flat, cushioned insole. If you have heel pain or pain in your arches, look for inserts that provide arch support and/or types that cushion and/or stabilize your heel. If you have pain at your arch, try arch supports.
Let comfort and support guide your choice. With hundreds of options available, Ferber says those considerations are the best rule of thumb for making a selection. “It may not sound scientific, but there’s actually plenty of evidence that an orthotic that feels comfortable and supportive for your needs is the one that will work the best for you," he says. "Everyone’s feet and walking patterns are slightly different. Wearing an orthotic that doesn’t feel right can make you change your gait. And even slight changes can cause injuries.”
Remember: If pain is severe or not helped within two weeks by an over-the-counter orthotic, it’s worth seeing a podiatrist for a diagnosis and pain-relief plan.
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