Foot orthoses - June 29, 2016
Are customised foot orthoses better for plantar heel pain?

Foot orthoses are a common intervention used for individuals with plantar heel pain. Two broad categories of foot orthoses are customised and prefabricated.

Customised foot orthoses, as the name suggests, are customised to the patient’s feet by taking an impression, cast or laser scan. The orthoses are then fabricated based on a prescription supplied by the practitioner. Prefabricated foot orthoses are manufactured to a generic shape, and are issued based on a patient’s foot size.

For plantar heel pain, numerous studies have compared the effectiveness of customised and prefabricated foot orthoses. Four randomised trials [1-4] have concluded that customised and prefabricated orthoses are equally effective at reducing pain at 12 weeks, and this conclusion has been echoed in a number of systematic reviews. [5-8]

Based on the current evidence, if your patient has plantar heel pain and no other reason to require a customised orthosis, then providing a cheaper prefabricated orthosis may be as equally effective as a customised orthosis to reduce pain.


Meta-analysis of customised vs prefabricated foot orthoses


  1. Baldassin V, Gomes CR, Beraldo PS. Effectiveness of prefabricated and customized foot orthoses made from low-cost foam for noncomplicated plantar fasciitis: a randomized controlled trial. Archives of Physical Medicine & Rehabilitation 2009;90(4):701-06 doi:
  2. Landorf KB, Keenan AM, Herbert RD. Effectiveness of foot orthoses to treat plantar fasciitis: a randomized trial. Archives of Internal Medicine 2006;166(12):1305-10 doi:
  3. Martin JE, Hosch JC, Goforth WP, Murff RT, Lynch DM, Odom RD. Mechanical treatment of plantar fasciitis. A prospective study. Journal of the American Podiatric Medical Association 2001;91(2):55-62 doi:
  4. Wrobel JS, Fleischer A, Crews RT, Jarrett B, Najafi B. A randomized controlled trial of custom foot orthoses for the treatment of plantar heel pain. Journal of the American Podiatric Medical Association 2015;104(4):281-94 doi:
  5. Hawke F, Burns J, Radford J, du Toit V. Custom‐made foot orthoses for the treatment of foot pain. Cochrane Database of Systematic Reviews 2008 doi:
  6. Martin RL, Davenport TE, Reischl SF, et al. Heel pain-plantar fasciitis: revision 2014. The Journal of Orthopaedic and Sports Physical Therapy 2014;44(11):A1-33 doi:
  7. Collins N, Bisset L, McPoil T, Vicenzino B. Foot orthoses in lower limb overuse conditions: a systematic review and meta-analysis. Foot Ankle Int 2007;28(3):396-412 doi:
  8. Landorf KB. Plantar heel pain and plantar fasciitis. BMJ Clinical Evidence 2015;11(1111)