Choosing an insole can quickly become confusing. Some products offer cushioning, others talk about support, and custom orthotics may be described as a more precise solution.
The useful starting question is what you need the insole to do. A more expensive or individually manufactured device is not automatically the right choice for every person.
Understand custom orthotics and other options
Off-the-shelf insoles are made in standard designs and sizes. Custom orthotics are made to an individual specification following an assessment. Some custom devices are produced using digital manufacturing, including 3D printing.
The manufacturing method is one part of the decision. Comfort, footwear, the condition being addressed and the response to using the device all matter. NHS orthotics services use both stock and custom devices where clinically appropriate.
Assessment comes before custom orthotics
Tell the clinician where you feel discomfort and which activities are difficult. Bring the shoes you wear for work, walking or running, because an insole needs to fit the footwear you actually use.
We may discuss your symptoms, examine relevant movement and consider how your feet manage activity. The aim is to decide whether an insole could be useful, rather than assume every person attending a gait assessment needs one.
Ask what success would look like
Before committing, ask which symptoms or tasks should improve and how long to try the device before review. Find out whether changes may be needed and what to do if it causes new discomfort.
A clear goal makes it easier to judge the outcome. Being able to walk to work more comfortably is more meaningful than a general promise to correct your alignment.
Keep the wider plan in view
Footwear, activity changes and exercise may also be relevant. An insole can form part of care for selected problems, but it should not be presented as a universal answer to pain elsewhere in the body.
For example, NICE advises against foot orthotics as a treatment for low back pain with or without sciatica. If the reason for recommending a device is unclear, ask for an explanation before buying it.
When to seek advice
Persistent foot pain, altered sensation or symptoms that affect normal walking deserve assessment. If you have diabetes and new foot pain, seek prompt medical advice rather than experimenting with products.
Explore our orthotics and gait assessment service to discuss the options. We will explain whether support is appropriate and how it would fit into a practical plan.
Further reading: NHS clinical guidance 1 · NHS clinical guidance 2 · NICE 3 · NHS 4
