Plain language guide, updated September 2026
Are Custom Orthotics Worth It?
Sometimes. For some foot problems they help, and for others a store-bought insert works just as well. Here's what the research says, in plain words.
Written by a clinic that offers custom orthotics · Reviewed by a registered physiotherapist
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The Short Version
- In trials, custom orthotics eased foot pain for people with painful high arches, rheumatoid arthritis in the feet, or bunions.
- For most heel pain, store-bought inserts did about as well as custom ones.
- For pain at the front of the knee, store-bought orthotics helped in the first 6 weeks, about as much as physio.
- For Achilles pain and knee arthritis, the research doesn't support them.
- At our clinic, orthotics are one part of a plan, and we often pair them with home exercises.
When Custom Orthotics Can Make Sense
These are the problems where the research is most encouraging, or where custom is the practical choice.
Painful high arches
In a trial of 154 people with painful high arches, custom orthotics eased foot pain more than a fake insert.
Rheumatoid arthritis in the feet
A review found custom orthotics eased pain at the back of the foot after 3 months, compared with no insert. After 3 years, they did no better than a fake insert.
Bunion pain
In one trial, custom orthotics eased bunion pain for the first 6 months. They don't change the bunion itself.
Flat feet with a sore inner ankle
In a small trial, people with a sore tendon on the inside of the ankle improved with orthotics plus strength exercise.
Store-bought didn't work
If store-bought inserts didn't help, or your feet are hard to fit, custom orthotics are worth a look.
When a Store-Bought Insert Is Enough
- Most heel pain. A 2018 review of trials found custom orthotics did no better than store-bought ones for heel pain. Stretching and strength work are part of the plan too. About plantar fasciitis
- Pain at the front of the knee. In a trial of 179 people, store-bought orthotics helped in the first 6 weeks, about as much as physio. Using both did about as well as physio alone. About front of knee pain
- Flat feet that don't hurt. Most flat feet are normal and need no treatment at all. About flat feet
- Trying inserts for the first time. A store-bought pair is a low-cost way to see if an insert helps.
When the Research Doesn't Support Them
Knee arthritis
In a 12-month trial of 200 people, wedged insoles did no better than flat insoles for knee arthritis pain. Osteoarthritis
Achilles pain
In a trial of 140 people, custom orthotics added nothing to calf exercise for Achilles pain. Achilles pain
Orthotics or Insoles: What's the Difference?
| Store-bought insert | Custom orthotic | |
|---|---|---|
| Made from | Standard shapes and sizes | A 3D scan or cast of your feet |
| Cost | Lower | $300 to $500 a pair at our clinic |
| Insurance | Rarely covered | Often covered, with a prescription |
| Often a good fit for | Most heel pain, front of knee pain, a first try | High arches, rheumatoid arthritis, bunions, hard-to-fit feet |
Thinking about insurance? Read what Ontario plans ask for before you order.
How Our Free Orthotic Assessment Decides
We listen
We ask about your pain, your work, your sport and your shoes.
We check
We watch you stand and walk, then check your feet, ankles, knees and hips.
We tell you
We tell you if a store-bought insert, custom orthotics or no insert makes the most sense for you.
The assessment is free. You only pay if you order custom orthotics, which cost $300 to $500 a pair.
Custom Orthotics Questions
Do custom orthotics fix flat feet?
They support your arch while you wear them. They don't change the shape of your foot, so we pair them with strength work for your feet and calves.
Will I need orthotics forever?
Not always. Some people wear them for a season while they build strength. Others like them long term. We look at this with you at your follow-up.
Can orthotics prevent running injuries?
Maybe. A 2017 review found fewer injuries with foot orthotics, but most of the trials were in military recruits. It's less clear for everyday runners.
Are store-bought insoles the same as orthotics?
Not quite. Store-bought insoles come in standard shapes and sizes. Custom orthotics are made from a scan or cast of your feet. For many problems they work about the same. Custom orthotics can suit feet that store-bought ones don't fit well.
How long do custom orthotics last?
It depends on how much you walk and what your pair is made of. Many pairs last a few years. The top cover often wears out first.
How do I know if I need orthotics?
Book a free orthotic assessment. We check your feet and how you walk, and tell you if a store-bought insert, custom orthotics or no insert at all makes the most sense.
Not Sure What Your Feet Need?
Book a free orthotic assessment in Ancaster. We'll tell you what makes sense, including when you don't need custom orthotics.
Free orthotic assessment · $300 to $500 a pair if you order · No referral needed to book
The Research in This Guide
- Hawke F, et al. Custom-made foot orthoses for the treatment of foot pain. Cochrane Database of Systematic Reviews, 2008. Summary
- Burns J, et al. Effective orthotic therapy for the painful cavus foot: a randomized controlled trial. Journal of the American Podiatric Medical Association, 2006. PubMed
- Whittaker GA, et al. Foot orthoses for plantar heel pain: a systematic review and meta-analysis. British Journal of Sports Medicine, 2018. PubMed
- Collins N, et al. Foot orthoses and physiotherapy in the treatment of patellofemoral pain syndrome: randomised clinical trial. BMJ, 2008. Full text
- Crossley KM, et al. 2016 patellofemoral pain consensus statement, part 2: recommended physical interventions. British Journal of Sports Medicine, 2016. PubMed
- Kulig K, et al. Nonsurgical management of posterior tibial tendon dysfunction with orthoses and resistive exercise: a randomized controlled trial. Physical Therapy, 2009. PubMed
- Bennell KL, et al. Lateral wedge insoles for medial knee osteoarthritis: 12 month randomised controlled trial. BMJ, 2011. PubMed
- Munteanu SE, et al. Effectiveness of customised foot orthoses for Achilles tendinopathy: a randomised controlled trial. British Journal of Sports Medicine, 2015. PubMed
- Bonanno DR, et al. Effectiveness of foot orthoses and shock-absorbing insoles for the prevention of injury: a systematic review and meta-analysis. British Journal of Sports Medicine, 2017. PubMed
This guide gives general information. Your physiotherapist or doctor can tell you what fits your feet.
Reviewed by Dhiman Patel, MScPT, registered with the College of Physiotherapists of Ontario. Last reviewed 23 September 2026.