Not always, and rarely on their own. The physical therapy clinical practice guideline for heel pain, revised in 2023, includes foot orthoses among its recommended options, and AAOS OrthoInfo says pre-made or custom shoe inserts are both helpful for plantar fasciitis. Inserts change how the foot is loaded; they do not build the flexibility and strength the heel needs. For most people, an off-the-shelf insert combined with calf and plantar fascia stretching, strengthening and sensible changes to standing and walking load is a sensible first step.
Last reviewed By the Monon Therapy Collective editorial team
What does the evidence say about orthotics for heel pain?
The heel pain guideline revised in 2023 by the Academy of Orthopaedic Physical Therapy, published in the Journal of Orthopaedic and Sports Physical Therapy, lists foot orthoses among the interventions it supports for plantar fasciitis, alongside stretching, taping, night splints and manual therapy. AAOS OrthoInfo puts it plainly: pre-made or custom orthotics are both helpful, and shoes with thick, cushioned soles reduce pain with standing and walking.
Neither source presents inserts as a stand-alone fix. OrthoInfo describes stretching the calves and plantar fascia as the most effective way to relieve the pain, so inserts belong in a package that also includes stretching, strengthening and education, not in place of them.
That makes sense when you consider what an insert does. It changes how load is shared across the foot while you stand and walk, but it does not build the strength or tolerance the plantar fascia and calf need to cope with that load once the insert comes out.
Are custom orthotics worth the extra money over off-the-shelf inserts?
For most people with plantar fasciitis, an off-the-shelf arch support is a reasonable first choice, because OrthoInfo treats pre-made and custom inserts as both helpful and does not single out custom devices. Custom orthotics cost considerably more and may not be covered by insurance.
Custom devices can still make sense when the foot shape is unusual, when there is a significant difference between feet, or when good prefabricated inserts have been tried for several weeks without benefit. A therapist may tape your foot first for short-term relief; if taping that supports the arch eases your pain, that is a useful clue that an insert doing the same job is worth trying.
| Question | Off-the-shelf insert | Custom orthotic |
|---|---|---|
| When it is usually tried | First line, often within the first weeks | After prefabricated inserts have not helped, or for unusual feet |
| Cost | Lower, bought at a store | Higher, made from a mold or scan |
| Time to get it | Same day | Days to weeks |
| What OrthoInfo says | Helpful | Also helpful; not described as better |
What else belongs in treatment alongside an insert?
Stretching the calf and the plantar fascia, strengthening the foot and calf, and adjusting how much you stand and walk on hard surfaces all belong in the plan. AAOS OrthoInfo calls stretching the calves and plantar fascia the most effective way to relieve the pain, describes a night splint as very effective for heel pain even though it takes getting used to, and lists soft silicone heel pads as an inexpensive option.
A therapist also looks at footwear, weekly step counts and the surfaces you spend time on. Teachers, nurses and warehouse staff standing on concrete all day face a different problem from a runner building up mileage for the Carmel Marathon in April. The plantar fasciitis page covers the full treatment approach, and the short foot exercise is one common strengthening drill.
- Calf and plantar fascia stretching, often first thing in the morning
- Progressive calf and foot strengthening
- Supportive shoes, worn indoors as well as out during a flare
- A night splint for stubborn morning pain
- Temporary changes to running or standing volume
How long until an arch support makes a difference?
Some people feel a change in the first week or two of wearing a supportive insert, because it changes how the heel is loaded from the first step. Others notice more gradual relief as the rest of the program takes effect.
Plantar fasciitis itself is often slow to settle. AAOS OrthoInfo reports that more than 90 percent of patients improve within 10 months of starting simple treatment, so give a combined program time before moving on to injections or other procedures. The page on how long plantar fasciitis lasts goes into typical timelines.
Give an insert a fair trial. Wear it in the shoes you use most, for most of the day, for two to four weeks, and keep doing the exercises alongside it. If pain has not changed at all by then, a different insert or a different approach is worth discussing.
When is heel pain not plantar fasciitis at all?
When the pain is at the back of the heel, when there is numbness or burning, or when it began after a fall or a sudden increase in impact, the cause may be different, and an orthotic aimed at the arch may miss it. Achilles problems, nerve irritation and stress fractures can all cause heel pain.
Children and young teens with heel pain during a growth spurt often have Sever’s disease rather than plantar fasciitis, and that is managed differently.
Morning heel pain that eases after the first few steps is the classic plantar fasciitis pattern, described on the page about heel pain in the morning. If yours does not fit, or you are not sure, start the questionnaire for a foot or ankle problem, and the matching team proposes a therapist in the network to examine it.
Related questions
Can orthotics make plantar fasciitis worse?
An insert that feels uncomfortable, too hard or too high can aggravate symptoms. Stop and get it checked if pain increases after you start wearing one.
Do I need orthotics forever once I have plantar fasciitis?
Not necessarily. Many people use them during recovery and then wear them only for long days on their feet or for running.
Should I wear orthotics in slippers at home?
During a flare, supportive footwear indoors helps many people, especially on hard floors. Going barefoot on tile or concrete often aggravates the heel.
Does insurance cover custom orthotics for plantar fasciitis?
Coverage varies widely, and many plans exclude them. Check with your plan before ordering a custom device.
Are heel cups as useful as full-length orthotics?
For some people, yes. OrthoInfo lists soft silicone heel pads, which raise and cushion the heel, among simple options, and they are cheap enough to try first.
Keep reading
- How long does plantar fasciitis last?
- Podiatrist or physical therapist for heel pain: who should I see?
- Should I use heat or ice for pain?
- Plantar fasciitis physical therapy in Carmel
- Running injury physical therapy in Carmel
- Choosing running shoes after an injury
Sources
This page is general education, not medical advice. A physical therapist can only advise on your situation after an examination.
