What if custom orthotics does not relieve heel pain?

Heel pain can come from different tissues, including the plantar fascia, a tendon, a joint, a nerve, or the heel bone. An insert changes how pressure is distributed, but it may not address every source of pain. The device may also need a fitting adjustment if it rubs, changes your walking pattern, or feels difficult to tolerate. Keeping a brief record of when pain appears, which shoes you wear, and whether the first steps after rest are worse can help the clinician reassess the problem.

Use the orthotics only as instructed and increase wearing time gradually if that was part of your plan. Check that they sit correctly inside suitable shoes and that the skin is not becoming sore. Reduce activities that clearly trigger pain for a short period, while maintaining comfortable movement. A clinician may recommend calf and foot exercises, changes to footwear, load modification, or another treatment after examining your heel. Do not reshape the device yourself.

Seek prompt medical assessment for severe pain after an injury, marked swelling, redness or warmth, fever, new numbness, weakness, or inability to bear weight. Arrange a routine review when symptoms persist, interfere with sleep or walking, or worsen despite following the plan.

Ask whether the orthotics fit your current shoes, whether the heel pain pattern suggests another diagnosis, how long to trial the device, and which exercises or activity changes should accompany it.