Feet Hurt? Slip in Some Relief With Shoe Inserts

Custom-made orthotics may help stamp out foot pain.


When your feet hurt, it’s hard to think about anything else, and everyday activities that involve standing or walking for more than a few minutes can become too daunting to attempt. Making good shoe choices can prevent problems, but for many of those who are already suffering, orthotics – shoe inserts designed to ease foot pain and correct structural issues – may provide much-needed relief.

Foot pain is common. One in four adults have some problem with their feet, and among people with certain types of arthritis, including rheumatoid arthritis (RA) and osteoarthritis (OA) of the knee, hip, ankle or foot, it’s even more prevalent.

Foot discomfort and structural problems such as the hammertoes and bunions caused by the inflammation of RA and lupus also can spread beyond the feet, leading to shin pain, knee pain and lower back pain.

Orthotics redistribute weight and relieve pressure on sensitive areas of the feet, provide cushioning that reduces stress, or biomechanical load, on the lower body, and correct gait and structural abnormalities, says Marian Hannan, associate professor of medicine at Harvard Medical School and co-director of Musculoskeletal Research at the Harvard-affiliated Institute for Aging in Boston.

“The best evidence of benefits with orthotics is for reducing foot pain in people with RA and lower extremity OA, Hannan says, noting, “The right insert may also help slow damage caused by knee OA.”

Research on orthotics and the course of knee OA are mixed. Although most studies find that people who wear orthotics have less foot pain and need fewer pain-relieving medications, some also suggest custom-made inserts can lead to long-term changes in biomechanics that may slow or prevent the progression of arthritis, says Hannan. 

“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.

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