Q: I have arthritis in both feet and several years ago was fitted for some hard, expensive plastic shoe inserts which I have never worn. Recently I have been having more foot pain. I am wondering if I should try the inserts.  However they are bulky and do not fit in many of my dress shoes. Have they been found to be really beneficial?

A: Middle of the foot arthritis is problematic with any standing and walking activity. Inserts may be helpful, but one downside with hard plastic inserts is that they really do not absorb shock.

If I utilize inserts, I typically ask for a cushioned, semi-rigid insert, which will hopefully immobilize the middle part of the foot but also cushion it a bit as well.

As you have stated, the one problem with any insert inside the shoe is that it takes up room, and there really is not anything that will fit successfully inside a dress shoe and still allow for comfortable shoewear.  If inserts do help, they would help when you are wearing them, but they are not going to provide any type of relief when you are not using them.