Custom insoles in Barcelona

Who needs orthotic insoles and who does not?

Not everyone with flat feet needs insoles. According to the NHS, flat feet usually do not cause problems, should not stop any activity or sport and do not need treatment if they do not bother you.²

If they hurt or are stiff, a foot specialist can advise on footwear, insoles, stretches, exercises and painkillers. These measures do not change the shape of the foot, but they help with pain or stiffness.²

On sport, the NHS says that flat feet should not stop it.² The sources cited do not detail specific insoles for each sport, and the CGCOP consent states that work or sport can influence the result.³

Custom-made or off-the-shelf insoles: what does the evidence say?

A systematic review with meta-analysis of insoles in heel pain (19 trials, 1660 participants) found no difference at any time between custom-made and prefabricated insoles. It found moderate-quality evidence that insoles reduce pain in the medium term compared with sham insoles, although it is uncertain whether the change is important in practice.¹

The sources cited do not compare the two types of insole in other problems, so there is no evidence here that paying for a custom-made insole gives a better result than an off-the-shelf one in heel pain.

Do insoles work for plantar fasciitis?

For plantar fasciitis, the NHS advises footwear with a cushioned heel and good arch support, and insoles or heel pads in the shoe; if it does not improve, a podiatrist may recommend insoles, suitable footwear or night splints.⁹ Insoles are a conservative treatment that increases the contact surface of the foot and redistributes its load.³

A systematic review with meta-analysis of foot orthoses in heel pain found moderate-quality evidence that they reduce pain in the medium term compared with sham orthoses, although it is uncertain whether the change is important in practice. That same review found no difference at any time between custom-made and prefabricated orthoses.¹ Therefore, the sources cited do not show that paying for a custom-made insole gives a better result than an off-the-shelf one for heel pain.

Insoles do not guarantee success in every case: the CGCOP consent warns that the result may depend on footwear, work or sport and postural habits, and that under no circumstances is the cost of the treatment refunded.³ The sources cited do not detail the risks of off-the-shelf insoles or heel pads.

How are they made and how many visits are needed?

The podiatrist makes a diagnosis that includes the biomechanical assessment of the foot and legs, and then chooses the materials and the design.³ The sources cited do not say how long the visit lasts, how many follow-ups are needed or how long the insoles last before being replaced.

According to the CGCOP consent, the diagnosis and design of custom-made supports are carried out by the podiatrist.³ On footwear, the NHS lists getting advice on footwear among the measures for a painful flat foot,² and the consent warns that unsuitable footwear can influence the result.³ The sources cited do not detail whether public healthcare or an insurer covers the insoles.

The price range observed by area is shown in the price table for each area.

What are the risks of insoles and what happens if they do not work for me?

Custom-made insoles are a conservative treatment that in some cases does not succeed, according to the informed consent of the CGCOP. The result may depend on unsuitable footwear, systemic diseases (those that affect the whole body), rehabilitation guidelines, work or sport and postural habits.³

If expectations are not met, the podiatrist will make the modifications and corrections they consider appropriate, but under no circumstances is the cost of the treatment refunded.³

• Custom-made insoles: they may not work and the cost is not refunded,³ and in heel pain they did not outperform off-the-shelf ones.¹
• Off-the-shelf insoles: the sources cited do not detail their risks.
• Not using insoles: a flat foot that does not bother you does not need treatment.²

When should you see the podiatrist or the doctor before buying insoles?

Seek advice before buying insoles if you have foot pain that does not improve or warning signs such as the following.

Flat feet

The NHS advises seeking advice if flat feet hurt, are stiff, weak or numb, if there are frequent foot or ankle injuries, problems walking or with balance, if you did not have flat feet before or if it affects only one foot.²

Heel pain

1. Non-urgent consultation: the pain is severe or stops you doing normal activities, gets worse or comes back, has not improved after 2 weeks of home care, there is tingling or loss of sensation in the foot or you have diabetes.⁴
2. Urgent care: severe heel pain after an injury, being unable to walk, a change in the shape of the foot or ankle, a snap or crunch when injured, dizziness or nausea from the pain, or swelling and bruising in the calf and ankle, because they may be signs of a fracture.⁴

Pain in the front of the foot

1. Non-urgent consultation: the pain stops you doing normal activities, gets worse or comes back, has not improved after 2 weeks of home care, there is tingling or loss of sensation in the foot or you have diabetes.⁵
2. Urgent care: severe pain, being unable to walk, a change in the shape of the foot, a snap when injured, dizziness or nausea, a hot, swollen and painful foot, or pain with a feeling of heat, cold or chills, because they may be signs of a fracture or infection.⁵

If you are pregnant

Swelling of the feet is common in pregnancy, but there are signs that need medical attention and are not resolved with insoles:

1. Sudden swelling of the face, hands or feet: it can be a sign of pre-eclampsia, and the NHS recommends telling the midwife, doctor or maternity unit straight away. Swelling that comes on gradually is not usually harmful.⁶
2. Throbbing pain and swelling in one leg only: it can be a deep vein thrombosis. Pregnancy and the six weeks after birth increase the likelihood, and the NHS asks for urgent medical attention if it is suspected.⁷
3. Sudden shortness of breath, chest pain or coughing up blood, even if your leg does not hurt: it is an emergency, because the clot can reach the lungs and put your life at risk.⁷⁸