Heel Cups and Heel Lifts
Reviewed by Andrew Schox, BSc(Hons) PGradDipPod MPod, October 2026
A heel cup sits under your heel inside your shoe. A heel lift raises the heel slightly to ease the pull on the tissues attached to your heel bone. Both are used as one part of care for heel pain, and lifts are also used to make up for a true difference in leg length. They suit people whose problem has been checked by a clinician. Expect a modest benefit, mostly in the short term. Use them with supportive shoes and any other treatment your podiatrist recommends, and wear them in gradually.
What is it?
A heel cup is a small device made of rubber, firm plastic (thermoplastic) or firm foam. It fits under your heel inside your shoe. A heel lift is designed to reduce the pull on the soft tissues that attach to your heel bone, and it can also cushion the heel. Lifts are also used to make up for a difference in leg length.
Both go at the base of the heel inside your shoe. Lifts come in different shapes, but they all do the same job. They are best seen as one part of a wider plan, not a stand-alone fix.
What is it used for?
The two main uses are pain under the heel (plantar heel pain) and a true difference in leg length. Heel cups and heel raises are used as one part of self-care for plantar heel pain. Shoe lifts are used for adults whose legs are different lengths and who also have a common painful muscle or joint problem.
Heel lifts are also used for pain in the Achilles tendon (the thick cord at the back of your ankle), and for heel pain in growing children caused by irritation at the back of the heel bone (calcaneal apophysitis). Some people with scoliosis (a sideways curve of the spine) and uneven legs are offered a lift too, although this is debated. A lift is only suggested in particular situations, such as a curve in the lower back on the shorter leg side.
Is it right for me?
A lift may suit you if you have a true leg length difference that has been confirmed by an assessment, especially if you also have a painful muscle or joint problem. A heel raise or heel cup may suit you if you have plantar heel pain and want a simple step to add to your self-care.
A lift is not a good idea if you only suspect your legs are different lengths and nobody has confirmed it. A lift that isn't needed can add pain instead of easing it. If you have loss of feeling in your feet (neuropathy), talk to your podiatrist before you start.
What happens?
Checking first. If a leg length difference is the issue, your clinician first works out whether it is a true difference in the length of the leg bones. They use measurements and an assessment of your pelvis, before an X-ray is needed. Sometimes a difference only looks real because of a bent limb or a stiff joint. A tape measure alone may not be reliable for some people, such as people with obesity or other bone and joint problems.
Choosing the height. For a leg length difference of 2 cm or less, a lift goes inside the shoe, with a thickness matching the difference. Most are 0.5 to 1.5 cm thick. For a difference of 1.5 to 2 cm, a raised sole or heel on the outside of the shoe is often more comfortable. For plantar heel pain, heel raises of 5 to 10 mm are part of the usual self-care advice. These heights come from practice advice rather than tested guidelines, so ask your podiatrist or physiotherapist to set the right height for you.
Shoes. Wear your heel cup or lift in a cushioned, stable shoe, such as a running trainer or walking shoe. Rigid or rocker soles can also help. A shoe with 8 to 10 mm of heel support is advised. Avoid flat or slip-on shoes.
Wearing in. Start with short periods and build up slowly as your foot gets used to it. If you have loss of feeling in your feet, use it for only 15 minutes to begin with.
How well does it work?
The honest answer is that the benefit is modest. The best evidence is for shoe inserts in general (foot orthoses), not heel cups or lifts on their own. How well a heel cup works alone for heel pain isn't clear yet.
For plantar heel pain, ready-made inserts gave a small gain in function at 3 months: 8.4 points better on a 0 to 100 scale, and 7.5 points better for custom-made ones, compared with a fake insert. That is just above the smallest change people usually notice (seven points). Pain scores also leaned in favour of the inserts, but the difference wasn't clear-cut. By 12 months there was no clear effect. Overall, inserts were not better than a fake insert or other simple treatments for pain and function. Ready-made and custom-made inserts worked about equally well.
Heel lifts looked better than an anti-inflammatory medicine (indomethacin) for plantar heel pain at 12 months. That result is very uncertain and may overstate the benefit. For Achilles tendon pain, heel lifts did better than calf exercises for pain (19.5 points on a 100 mm pain scale). The difference was small enough that you may not notice it. In children with heel pain from growth, heel lifts were less helpful than custom-made inserts at 12 weeks, with no difference from ready-made inserts. By 6 and 12 months, there was no difference between the options.
For leg length differences, shoe lifts are linked to less pain and better function, but the evidence is low quality. Around 88 per cent of people treated with a shoe lift had partial or complete pain relief. A lift's effect on the pelvis is hard to predict, because only about half of it passes through to the tilt of the pelvis.
Compared with other options. For adults with plantar heel pain, contoured full-length insoles relieved symptoms better than heel cups. Combining insoles with night splints or rocker shoes worked better than any one of them alone. Simple advice plus a heel cup is a reasonable first step. Adding exercise or a steroid injection made no clear extra difference over 12 weeks. A steroid injection may help in the short term but may have negative long-term effects, so discuss it with your doctor.
Risks and side effects
The problems reported are mostly minor. How often they happen isn't known. A new heel cup or insole can leave some marking on a child's skin. The skin should not blister or break down. Heel cups may make your foot sweat more, so wash your feet and change your socks more often. Your feet, legs, upper thighs or lower back may ache when you first wear a new insole. This should not be significant pain, and it should settle quickly if you build up wear gradually.
In people using heel lifts for Achilles tendon pain, side effects were similar to those with calf exercises. They included new pain in the lower back, hips, knees, feet or ankles, and blisters. One report linked a heel lift worn when there was no leg length difference to long-lasting pain deep in the hip and groin.
Check the skin on your feet after wearing a new device. If you have loss of feeling in your feet, check them after every wear for damage, redness, blistering or bruising. If a child's skin shows significant marking, take the device off and look at the foot again after 30 minutes.
Afterwards
Keep building up wear gradually and keep using supportive shoes. Pair your heel cup or lift with any other treatments your podiatrist recommends. Set realistic goals with them, because the benefit may be mainly short-term. For plantar heel pain, if you haven't improved after about 3 months of self-care, ask about seeing a podiatrist for review.
How long you need to keep wearing a heel cup or lift, and how many visits you need, isn't clear yet. Your podiatrist can advise what suits you.
When to see a podiatrist
When to book
Book an appointment with your podiatrist if you have heel pain and diabetes, or heel pain with tingling or numbness. Also book if you suspect one leg is shorter and want it checked before using a lift, or if your plantar heel pain hasn't improved after 3 months of self-care. For a child, book a review with a health professional if symptoms are new or getting worse, or if significant skin marking from a heel cup or insole is still there 30 minutes after taking it off (an orthotist, a specialist who makes and fits supports for the feet, can review it). A heel cup or lift is not a substitute for assessment.
When to get help sooner
If you have loss of feeling in your feet and notice damage, redness, blistering or bruising, stop using the heel cup or lift and contact your podiatrist straight away. If new pain appears in your hip, groin, knee or back after you start using a lift, stop using it and have it reviewed by your podiatrist or another health professional.
Frequently asked questions
Will a heel lift fix my back, hip or knee pain?
Not necessarily. A difference in leg length is linked to low back pain, scoliosis and arthritis in the hip and knee, but this link doesn't show that a lift treats those problems. Lifts for scoliosis are debated. Ask your clinician whether a true leg length difference is behind your pain before you try one.
Do I need a scan before I get a heel cup?
Usually not. Heel pain is mostly diagnosed from your story and a physical examination. The location of the pain and the absence of signs of illness elsewhere in your body strongly point to the cause. Scans such as X-rays are used only if the diagnosis is unclear or surgery is being considered.
Does my child need heel cups or special shoes for flat feet?
Usually not. Flat feet in young children tend to improve with growth, whatever shoes they wear. Corrective footwear has shown no benefit over ordinary shoes in infants and young children. There is no strong evidence that long-term inserts change the structure of a child's flat feet.
Is a heel cup easier to stick with than exercises?
Generally, yes. Shoe inserts need less effort to keep up than exercises or stretching, which matters if you find a routine hard to stay on top of. Because they are not clearly better than other simple treatments for heel pain, choose what you can realistically stick with, and talk it through with your podiatrist.