Most People With Foot Pain Don’t Need Custom Orthotics
That might sound strange coming from a clinic that offers custom orthotics in Surrey. But it’s true. Many people are told they need an expensive pair of inserts when stretching, better shoes or a few weeks of physiotherapy would have done the job.
Custom orthotics can be a great tool for the right person. The trick is knowing whether that person is you. Let’s look at what orthotics do, what the research says, who benefits most, and how insurance coverage works in BC.
What Are Custom Orthotics?
Custom orthotics are shoe inserts made from a 3D mould or scan of your feet. They’re built to fit your foot shape and change how pressure spreads across your foot when you stand, walk or run.
Off-the-shelf orthotics (also called prefabricated insoles) come in set shapes and sizes. You can buy them at a pharmacy or running store, often for a fraction of the price.
Here’s how the two compare:
| Custom orthotics | Off-the-shelf orthotics | |
|---|---|---|
| How they’re made | From a mould or scan of your feet | Mass produced in set sizes |
| Fit | Matched to your foot shape | General fit, sometimes adjustable |
| Cost | Higher | Lower |
| Insurance | Often partly covered with the right paperwork | Usually not covered |
| Wait time | Usually a few weeks | Same day |
Think of it like glasses. Reading glasses from the drugstore work well for lots of people. Others need a prescription pair because their eyes need something more specific. Feet are similar.
What the Research Says About Custom Orthotics
So, do custom orthotics work? The honest answer is sometimes, and it depends on what’s causing your pain.
Heel pain (often called plantar fasciitis) is the best-studied example, and it shows why the answer isn’t simple. A 2021 best-practice guide pulled together 51 studies on treating heel pain (Morrissey et al., 2021). In the trials it reviewed, custom orthotics gave some short-term pain relief, but the results didn’t line up from one study to the next. Some trials found a clear benefit, while others found very little.
Because the evidence is uneven, the guide doesn’t put orthotics first. It recommends starting with stretching, taping and education about footwear and load for about six weeks. If pain hasn’t eased, shockwave therapy comes next. Custom insoles come after that, for people whose pain still hasn’t settled.
In other words, orthotics can help, but they’re rarely the first or only answer. When they do make a difference, here’s why.
Why orthotics can help
Pain isn’t only about damaged tissue. It’s your nervous system’s way of saying, “This area feels under threat.” When a spot in your foot becomes sensitive, everyday loads like walking to the bus can start to hurt.
An orthotic can shift some of that load away from the sore area for a while. That gives the tissue a calmer environment while you build strength and tolerance. It works best as one part of a plan, not as the whole plan.
Who May Actually Need Custom Orthotics?
Custom orthotics are most likely to be worth it in a few situations:
- Your heel or arch pain hasn’t improved after several weeks of stretching, strengthening and footwear changes.
- You have diabetes with reduced feeling in your feet, and your care team wants to protect areas at risk of sores.
- You have rheumatoid arthritis or another condition that has changed the shape of your feet.
- Your foot shape is quite different from average, like a very high arch or a stiff, flat foot, and store-bought insoles don’t fit or help.
- You’ve had foot surgery and your surgeon or physiotherapist recommends extra support while you recover.
Even in these cases, orthotics usually work alongside other care. Strength, mobility and smart load changes still matter.
Who Probably Doesn’t Need Custom Orthotics
You can likely skip custom orthotics, at least for now, if one of these fits:
- You have flat feet but no pain. Flat feet are a normal variation for many people.
- Your foot pain started recently and hasn’t had a fair trial of simpler care.
- Off-the-shelf insoles already make you comfortable.
- You were told orthotics will “fix your alignment” or cure back pain. There isn’t good evidence for that.
What to try first
For most foot pain, start with these steps:
- Check your shoes. Look for a supportive pair that fits well and isn’t worn down.
- Ease back on the activity that flares your pain, without stopping all movement.
- Stretch your calves and the bottom of your foot each day.
- Build strength in your feet and calves over a few weeks.
- Try a good off-the-shelf insole if you want extra comfort.
- Book a physiotherapy assessment if pain isn’t improving after a few weeks.
Getting Custom Orthotics in Surrey: How It Works in BC
Who provides them
Custom orthotics are usually made and fitted by a podiatrist (a foot doctor), a pedorthist (a certified foot orthotic and footwear specialist) or an orthotist. A physiotherapist often does the hands-on assessment of how your feet, ankles, knees and hips move, and works with these providers on the orthotic itself.
How insurance coverage usually works
Many people pay for custom orthotics through an extended health plan from work. Plans differ, but insurers commonly ask for the following items:
- a prescription that lists your medical diagnosis
- a prescription from a provider your plan accepts, which can differ from plan to plan
- a copy of your biomechanical assessment or gait analysis
- proof the orthotics were made from raw materials using a 3D cast or scan of your feet
- a lab bill that describes the casting method used
If a single item is missing, your claim may be denied, so it pays to check first.
Questions to ask your insurer before you book
A quick call or a look at your benefits booklet can save you a surprise bill. Ask these questions:
- Whose prescription do you accept: a doctor, a podiatrist or a physiotherapist?
- How much is covered, and how often can I claim a new pair?
- Do you need a gait analysis or a specific casting method?
- Which providers can make and dispense the orthotics?
What to Expect at a Custom Orthotics Assessment
At Clayton Heights 188 St Physiotherapy and Sports Injury Clinic, a visit for foot pain starts with finding out what’s actually going on. A typical assessment follows these steps:
- We ask about your pain, your activity, your work and the shoes you wear most.
- We look at how you stand, walk and, if it’s relevant, run.
- We test the strength and movement of your feet, ankles, knees and hips.
- We explain what we found and talk through your options, including whether orthotics are likely to help.
- If custom orthotics make sense, a podiatrist, pedorthist or orthotist captures the shape of your feet with a cast or 3D scan.
- That same provider has your orthotics made, then checks the fit and shows you how to break them in.
If orthotics aren’t the right fit, physiotherapy can still help with strength, mobility and a plan to ease you back into the activities you enjoy.
The Bottom Line on Custom Orthotics in Surrey
Here’s what to remember:
- Custom orthotics help some people, but most foot pain improves with simpler care first.
- The research supports orthotics as one part of a plan, not a stand-alone fix.
- They’re most useful when pain hasn’t settled, or when a health condition or foot shape calls for something specific.
- Check your insurance requirements before you book so your claim goes through.
Not sure whether orthotics are right for you? Come see our physiotherapy team in Surrey. We’ll take a close look at your feet, tell you plainly what we think, and help you get moving comfortably again, with or without orthotics.
References
Morrissey, D., Cotchett, M., J’Bari, A. S., Prior, T., Griffiths, I. B., Rathleff, M. S., Gulle, H., Vicenzino, B., & Barton, C. J. (2021). Management of plantar heel pain: A best practice guide informed by a systematic review, expert clinical reasoning and patient values. British Journal of Sports Medicine, 55(19), 1106–1118. https://doi.org/10.1136/bjsports-2019-101970
Pacific Blue Cross. (n.d.). Orthotic claim. https://www.pac.bluecross.ca/advicecentre/story/orthotic-claim