I had orthotics, but I always hated them. I recently saw Dr Phillip Snell, a chiropractor on Hawthorne who agreed with me when I said I had decided to give up the damn things and try to get my feet to work more as nature intended. I put orthotics in the same category as weight lifting belts that you see folks wearing at gyms and Walmart. Instead of the body holding itself in alignment, it is being held by an external aid. (While some people may need orthotics for structural defects, I never really needed them. I needed to be more aware of muscle imbalances and course correct.)
So, I've been trying to get my feet and ankles to be stronger and less tender. I haven't completely given up shoes, but I do go barefoot more, wear different types of shoes, and have been doing more foot work exercises on the Pilates Reformer (which seems to do the most good).
I'm mixin' it up and cross training my feet. Whoohoo!