# Off-the-shelf orthotics

> Off-the-shelf orthotics (prefabricated orthoses) are ready-made insoles, usually foam, that a podiatrist can adjust to your foot. For adult heel pain they may help a little, and custom insoles give similar results. Mild aching at first is normal.

Guide in [Treatments](https://footanklelowerlimb.com.au/learn/topics/treatments), from Foot Ankle Lower Limb: https://footanklelowerlimb.com.au/learn/prefabricated-orthoses
Reviewed by Andrew Schox, BSc(Hons) PGradDipPod MPod (Podiatrist) on 27 October 2026.
Next review by 27 October 2027.

- **They're ready-made insoles,** usually foam, that a podiatrist can adjust to suit your foot.
- **The benefit for heel pain is small,** so they suit being one part of a plan rather than the whole of it.
- **Custom isn't clearly better:** for adults with heel pain, pre-made and custom insoles gave similar results.
- **Some aching at first is normal,** but pain, rubbing or skin damage means stop and get advice.
- **Take extra care with diabetes or numb feet,** and involve a health professional first.

## What are off-the-shelf orthotics, and how do they work?

Prefabricated orthoses (off-the-shelf orthotics) are pre-made insoles, usually made of foam, that can be modified to suit your foot [1]. Custom orthotics, by contrast, are made for your individual foot [1]. "Pre-made" covers both basic shop-bought insoles and off-the-shelf devices that a podiatrist adjusts for a specific problem [3].

Insoles are designed to guide your foot so it works more efficiently [1], or to take pressure off a sore area [2].

## What are they used for, and how well do they work?

Heel pain in adults is the best-studied use, and the benefit is small. Insoles may ease pain a little in the medium term, though that may not be enough for some people, and the full effect may take 7 to 12 weeks [4]. They don't seem to beat fake insoles or other simple treatments for pain and function [5].

For children with flat feet the picture is mixed. Insoles may reduce pain, but the evidence is low quality [6]. For painless flexible flat feet they made little or no difference to pain after a year [7]. There's no strong evidence that long-term use changes the structure of a child's flat feet [7]. For children with painful flat feet, it isn't clear yet whether orthotics are worth it [8].

Keep expectations realistic: people can expect a lot from insoles and be disappointed [8]. For most other foot and leg problems, how well pre-made insoles work isn't clear yet.

## Are they right for me?

A podiatrist can assess how your feet and legs work, along with your footwear, work and lifestyle, to see whether orthotics are likely to help [3]. For heel pain, clinicians are advised not to give insoles to everyone, and to consider your preferences and how likely you are to wear them [5]. One advantage is that insoles take less effort to keep up than exercises or stretching [5].

For children with painless flexible flat feet, there's no support for expensive custom orthoses [7]. A child with ongoing foot pain should be assessed by a health professional, because flat-foot pain is often put down to growing pains [8].

> [!see] If you have diabetes or numb feet
> Get advice from a health professional before using insoles, because you may not feel damage from them [9]. With loss of feeling, begin with only 15 minutes of wear and check your feet after every wear [9].

## What happens when I get them?

A podiatrist will usually start by assessing your feet, legs and footwear [3]. A pre-made device can be fitted on the day [2]. Prescribing commonly includes advice and some adjusting of the insole [10]. Your podiatrist can tell you how many visits you'll need.

Wear the insoles in supportive shoes that have a removable insole and fasten securely with laces, a buckle or a strap [11]. Follow the wearing-in schedule your clinician gives you. For heel pain, give them several weeks before deciding whether they help.

## What are the risks and side effects?

Side effects are usually mild. Aching in your feet, legs, thighs or lower back, a lump felt in the arch, or muscle tiredness can happen at first as your body adjusts, and should settle within a few days [12][13]. Insoles shouldn't cause pain, redness or rubbing [11].

After taking them out, look for redness or pressure marks that don't fade within 30 minutes, blisters, cuts, rubbing areas, or swelling or pain in your feet or ankles [12]. If you notice any, stop wearing the insoles, then build up wear time slowly again and wait for blisters to heal [12].

## How do they compare with other options?

For adults with heel pain, pre-made and custom insoles gave similar pain and function results [14][4], and well-contoured pre-made ones may cost less [4]. The shape of the arch support may matter more than whether it's custom-made [15]. If a custom device is recommended for heel pain, it's reasonable to ask why, given the extra cost.

No commonly used heel pain treatment, insoles included, comes out clearly ahead of the others [14]. Insoles weren't effective on their own but were mostly effective combined with shockwave therapy [14], so ask whether they should be paired with another treatment. This evidence is mostly about heel pain in adults and may not apply to other conditions or to children.

## When to see a podiatrist

Stop the insoles and contact the clinician who prescribed them if you have severe or lasting pain, redness, rubbing or blisters. Do the same if pain or pressure lasts beyond the first week, your walking or pain changes significantly, or the insoles feel worn or unstable [12]. Bring the insoles with you.

See your GP or a podiatrist the same day if you have diabetes or loss of feeling and notice any skin damage, redness, blistering or bruising [9]. Do the same if anyone's foot becomes red, warm or swollen, or has an open wound, discharge or blood [16]. Don't wait for your next appointment. For urgent advice when it isn't an emergency, call healthdirect on 1800 022 222 (24 hours a day), or go to a Medicare Urgent Care Clinic.

See a podiatrist if your child has ongoing foot pain [8]. If you have heel pain, ask whether insoles suit you as one part of a plan.

## Common questions

### How long do prefabricated insoles last?

They can last between 12 and 24 months, depending on how much you use them and the type. They aren't replaced after a set time. Bring them to review appointments so a clinician can check for wear, and book a review if your pain or discomfort returns or the insoles wear out.

### Can I just buy insoles from a shop?

Shop-bought insoles are one kind of off-the-shelf insole, and there are many types. A podiatrist can check how your feet and legs work, your footwear and your activities, and advise whether a pre-made device is enough for your problem. It's worth asking first if your pain is ongoing or the insoles are for a child.

## Further reading

- [Off-the-shelf orthotics on Clindice](https://clindice.com/prefabricated-orthoses)
- [Insoles – Information for patients and carers | Digital Patient Information Hub - Bradford Teaching Hospitals - NHS Foundation Trust](https://digitalpatientinformationhub.bradfordhospitals.nhs.uk/leaflets/insoles/), NHS
- [Orthotics - OrthoInfo - American Academy of Orthopaedic Surgeons](https://www.orthoinfo.org/treatment/orthotics/), OrthoInfo (American Academy of Orthopaedic Surgeons)
- [Offloading insoles](https://www.oxfordhealth.nhs.uk/wp-content/uploads/sites/44/2024/02/OH-008.24-Podiatry-Offloading-insoles.pdf), NHS
- [A guide to your insoles :: Dorset HealthCare University NHS Foundation Trust](https://www.dorsethealthcare.nhs.uk/our-services-and-sites/physical-health/orthotics-insoles-braces-and-supports/guide-your-insoles), NHS
- [Purchasing Off The Shelf Orthotics to Manage Common Foot Pains](https://dchft.nhs.uk/leaflets/purchasing-off-the-shelf-orthotics-to-manage-common-foot-pains/), NHS

## Sources

1. Foot orthotics · Health New Zealand | Te Whatu Ora. https://www.healthnz.govt.nz/health-topics/conditions-treatments/feet-and-ankles/foot-orthotics
2. Foot orthoses (insoles) · NHS. https://www.rightdecisions.scot.nhs.uk/patient-information-leaflets/primary-community-services/podiatry-orthotics/foot-orthoses-insoles/
3. Foot orthoses · Better Health Channel. https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/foot-orthoses
4. Foot orthoses for plantar heel pain: a systematic review and meta-analysis · Whittaker GA, Munteanu SE, Menz HB et al. · British Journal of Sports Medicine · 2018. https://doi.org/10.1136/bjsports-2016-097355
5. Efficacy of foot orthoses for the treatment of plantar heel pain: a systematic review and meta-analysis · Rasenberg N, Riel H, Rathleff MS et al. · British Journal of Sports Medicine · 2018. https://doi.org/10.1136/bjsports-2017-097892
6. The effectiveness of non-surgical intervention (Foot Orthoses) for paediatric flexible pes planus: A systematic review: Update · Dars S, Uden H, Banwell HA et al. · PloS One · 2018. https://doi.org/10.1371/journal.pone.0193060
7. Foot orthoses for treating paediatric flat feet · Evans AM, Rome K, Carroll M et al. · The Cochrane Database of Systematic Reviews · 2022. https://doi.org/10.1002/14651858.cd006311.pub4
8. OrthoticS for TReatment of symptomatic flat feet In CHildren (OSTRICH): a randomised controlled trial · Cockayne S, Baird K, Gates S et al. · Health Technology Assessment (Winchester, England) · 2026. https://doi.org/10.3310/plkj4541
9. Information about your insole or foot orthoses · NHS. https://www.esht.nhs.uk/wp-content/uploads/2020/09/0840.pdf
10. Management of plantar heel pain: a best practice guide informed by a systematic review, expert clinical reasoning and patient values · Morrissey D, Cotchett M, Said J'Bari A et al. · British Journal of Sports Medicine · 2021. https://doi.org/10.1136/bjsports-2019-101970
11. Orthotic instructions · Kent Community Health NHS Foundation Trust · 2023. https://www.kentcht.nhs.uk/leaflet/insoles/
12. Orthotic Insoles · NHS. https://www.uhb.nhs.uk/media/eebmdzz4/orthotic-insoles-orthotics-pi.pdf
13. Insole · NHS. https://www.ouh.nhs.uk/media/13zh31sk/110157insole.pdf
14. Comparative effectiveness of treatment options for plantar heel pain: a systematic review with network meta-analysis · Babatunde OO, Legha A, Littlewood C et al. · British Journal of Sports Medicine · 2019. https://doi.org/10.1136/bjsports-2017-098998
15. Contoured, prefabricated foot orthoses demonstrate comparable mechanical properties to contoured, customised foot orthoses: a plantar pressure study · Redmond AC, Landorf KB, Keenan AM · Journal of Foot and Ankle Research · 2009. https://doi.org/10.1186/1757-1146-2-20
16. A Guide to Your Insoles · Bedfordshire Hospitals NHS Trust · 2024. https://www.bedfordshirehospitals.nhs.uk/patient-information-leaflets/a-guide-to-your-insoles-2/

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This page is general information, not a diagnosis or a treatment plan for you. For advice about your own feet or legs, see a podiatrist or your doctor. In an emergency, call 000.