There seems to be an assumption by some health care providers that orthotics are necessary for anyone presenting with plantar heel pain (PHP). I am neither anti-orthotics nor pro-orthotics but in my humble opinion, they are way over-prescribed.

The highest predictor if someone is prescribed orthotics appears to be if the health care provider a patient is seeing makes them and if the patient has $500 insurance coverage to pay for them.

A 2018 systematic review based on 20 high quality RCTs on the use of orthotics and PHP came up with the following 3 conclusions.

i) There was no difference between custom orthoses and sham orthoses

ii) There was no difference between prefabricated orthoses and sham orthoses

iii) There was no difference between prefabricated orthoses and custom orthoses

There are certainly SOME who benefit from orthotics but as the studies show, orthotics prescribed to everyone with PHP is unjustified and irrational.

 

Reference: Rasenberg N et al Efficacy of foot orthoses for the treatment of plantar heel pain: a systematic review and meta-analysis. Br J Sports Med. 2018 Aug;52(16):1040-1046.

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