Different feet require different types of arch support—something that’s especially important for people with arthritis. Most shoes out there come with “normal” arch support, while some brands and styles may also be available in a high or low arch. “Those with a low arch are known to pronate, and so they should look for an anti-pronator type of shoe,” Dr. Pinker explains. “Those with a high arch have a tendency to supinate, and so footwear that prevents over-supination is recommended; however, these types of shoes are not easy to find.”   And if you’re unable to find shoes with the arch support you need, your next best bet is using orthotics—either prefabricated or custom-made. “Orthotics or insoles are the only devices that place the foot in ‘neutral’ by providing the correct tilt in the heel as well as arch support,” Dr. Lobkova explains. While potentially helpful, buying over-the-counter orthotics can be tricky, because you might not know which kind would work best for you, and as they are made of flexible material, they provide limited support.  “Custom orthotics, if made correctly, can provide adequate support to decompress the great toe joint (increase the joint space), minimize excessive motion in the midfoot, realign the subtalar and ankle joints, and alleviate pain,” Dr. Lobkova says. To determine how much arch support and tilt your feet require, your podiatrist will use X-ray imaging and gait analysis.