This study compared the effectiveness of soft versus hard orthotics in treating heel pain associated with plantar fasciitis in adults. It also compared the level of function after orthotic use, cost and number of visits for orthotics and explored if age was a factor in orthotic effectiveness. This randomized trial included 44 adults with heel pain associated with plantar fasciitis. Participants received hard or soft customized orthotics and rated their pain intensity, pain interference, and function, pre and post orthotic use. Scores were analyzed with repeated measures ANOVA and showed a reduction in pain intensity (P=0.010) and pain interference (P<0.001), but no change in function (P=0.333) over time, and no difference between the two groups. Soft orthotics cost less (P<0.0001) and required fewer visits (P<0.0001) for fabrication. There was no difference in outcomes by age. Both soft and hard orthotics provided effective pain relief, however, soft orthotics were less expensive.