Custom Orthotics Vs Over-The-Counter Inserts: Pros And Cons

Orthotics and inserts can make a huge difference to your feet.

If you find it hard to find shoes that fit comfortably and support them the way you need, then these types of additions could be the best way for you to find a perfect fit.

Inserts and orthotics can help reduce pain in the foot, ankle, knee, hip, and even lower back. It also lessens the chance of injury and helps improve your gait.

But how do you know if they need custom orthotics vs over-the-counter inserts?

Let’s have a look at the pros and cons of each so you can choose the right one for your feet.

What Are Orthotics and Inserts?

The terms “orthotic” and “insert” are often used interchangeably. And while there are similarities, they are different in some specific ways.

Both orthotics and inserts are placed inside the shoe and are designed to provide cushioning, reduce foot pain, realign the foot and decrease abnormal foot motion.

The biggest difference between the two is that orthotics are custom-made to your specific foot shape by either a podiatrist or an orthopedist.

Inserts are mass-produced devices that are available online and in most stores. You’ll find them in multiple sizes with a “trim to fit” design and geared to a wide range of activities like walking, hiking, basketball, and running. Popular brands include: Superfeet, Currex, Spenco, and Powerstep.

Custom orthotics are made from firmer and stronger material, like EVA or plastic. This makes them last longer as they don’t lose their shape due to compression. Inserts tend to flatten and wear out faster, as they’re made from softer and less durable material like foam or gel.

There are inserts that are designed for men and women. You’ll also get to choose from firm to ultra-firm inserts and you can shop according to specific foot conditions as well.

Orthotics May Be Recommended for Several Reasons

There are a number of medical conditions that may require using an orthotic. Doctors may even recommend orthotics to people who have experienced an injury to their feet or ankles, as they can increase the healing process.

But orthotics are also recommended for people who need support and alignment for their foot or ankle or to improve the overall function of the foot or ankle. Orthotics are used to not only accommodate for foot deformities but also to prevent or correct them.

Doctors may recommend orthotics to people who have diabetes, as they can reduce the chance of developing an open sore on their foot. Diabetics are at a high risk of wounds on the feet and legs becoming infected, which could lead to amputation.

Orthotics may also be recommended to people who have very high arches or flat feet and who aren’t able to get adequate support from their regular shoes.

The Basics About Custom Orthotics

Getting a custom orthotic fitted is a multi-step process.

First, the podiatrist has to examine and assess your foot. Then, a cast of your foot will be made so that it fits and supports your exact foot shape.

The orthotic is then manufactured and you’ll have a fitting of your new orthotic with your podiatrist.

This whole process can take up to two weeks and custom orthotics can cost between $200 to $800 dollars. Depending on your insurance, they may or may not be covered.

You may need to have the tops of the orthotics resurfaced—replace the top surfaces— when they wear out, which can cost an additional $50 to $100 dollars.

Pros of Custom Orthotics

  • Customized to fit and support your exact foot shape
  • Has a longer lifespan than inserts and can last between 2 to 5 years
  • Custom orthotics allow for ongoing ability to modify the device
  • A variety of materials are used to provide more support, comfort, and increased function
  • Aligns the ankle and foot
  • Improves foot and ankle function
  • Provides exact support for foot deformities
  • Can be used to prevent foot deformities

Cons of Custom Orthotics

  • Finding and scheduling an appointment with an orthopaedist or podiatrist can be time-consuming
  • Can take up to 2 weeks to make the orthotics
  • Custom-made orthotics are much more expensive than inserts

Consider Over-The-Counter Shoe Inserts For

If you don’t have any serious health issues—such as diabetes—and you’re looking for an insert that can provide cushioning and pain relief, then consider over-the-counter inserts (often referred to as OTC).

Over-the-counter insoles can provide relief from mild to moderate pain for conditions such as metatarsalgia, plantar fasciitis, or heel spurs. They can also provide comfort, relief and help prevent fatigue in the legs for people who spend most of their day on their feet. Some inserts can even help your shoes fit.

If you want more comfort for physical activities such as running, walking, playing soccer, or basketball, then it may be best to use an over-the-counter insert.

Specific Features to Look For In OTC Insoles

There’s a variety of over-the-counter inserts to choose from and there are some specific features that you should take into consideration. This will ensure that you’re getting the right support for your foot shape.

The first thing that you want to look for is multiple arch heights. If you have a high arch or flat feet, then a neutral insert will not work for you. The arch of your insole needs to match the contours of your foot.

This will provide full contact for the length of your arch, which will help to distribute your body weight evenly, reducing the pressure on the structures of the foot. This will help reduce your risk of metatarsalgia, collapsed arches, and Morton’s neuroma.

Next, you want to make sure that the insert that you’re getting is made from durable, high-quality materials.

Inserts that are made from medical-grade support tend to be firmer and will be able to withstand the amount of pressure that’s placed on them. This will also help to prevent foot fatigue and reduce foot pain.

Our feet have a fatty pad in the heel—plantar fat pad—and as we get older this heel pad can get thin—atrophy—reducing our foot’s natural shock-absorbing ability. This can lead to painful foot conditions, such as heel spurs and plantar fasciitis.

When you’re looking for inserts, also make sure that they feature a deep heel cup as this will help protect and enhance your foot’s shock absorption. A deep heel cup will also provide more stability and comfort with every step you take.

Pros of Over-The-Counter Insoles

  • Wide selection to choose from
  • Easily accessible
  • Inserts are more affordable
  • Increases or enhances the comfort level of your shoe
  • Reduces muscle fatigue in legs and feet
  • Can provide relief for mild to moderate pain
  • Helps with mild foot conditions

Cons of Over-The-Counter Insoles

  • May not fit all foot types
  • They have a shorter lifespan and last for 6 months to a year
  • Don’t provide enough support for serious conditions

Dos and Don’ts for OTC Inserts and Custom Orthotics


  • Take your shoes with you when you’re getting inserts
  • Make sure that the shoe has enough depth to accommodate either the custom orthotic or OTC insert.
  • The shoe must have a removable insole (unless it’s an insert for dress shoes, which are shorter and will fit into low profile shoes).
  • Before purchasing an insert, discuss your concerns and symptoms with your doctor and ask for their advice.
  • Make sure that you match the inserts with your arch support.
  • Remove the insole of the shoe before adding the insert. By placing the insert on top of the shoe’s insole, you could be making it more uncomfortable.
  • Decide if you want to switch one set of inserts between shoes or if you need two or more sets for different shoes.


  • If the shoe is worn and the cushioning is flat, don’t buy an insert as the shoe will not provide adequate support. Buy new, supportive shoes instead.
  • Don’t guess the size of the insert that you need. Always follow the sizing guide if buying online or speak to your foot care clinician in-store to help you get the right size.
  • Don’t buy inserts that are made from soft, floppy gel. While they may feel comfortable, they don’t always provide the support that your foot needs and they tend to break down quicker.
  • Avoid neutral inserts if you have flat feet or high arches, as they won’t provide enough support.
  • Similarly, if you have a neutral foot, avoid inserts that are designed specifically for high arches or flat feet.
  • Don’t buy arch supports that are smaller than you need. This will lead to discomfort.
  • Replace your inserts every 6 months or thereabout.