I have tendonitis after the tibia and plantar fasciitis. These are currently the only shoes I can wear that don't cause a lot of pain, and that's after 2 years of treatment and doctors. They have moderate arch support for anyone with a moderate arch. If you have a high or low arch, you may still need some form of orthotics. I use them with full size Protalus M100 orthotics and they are near perfect. The only issue I have is that this 18 is slightly smaller than the 17 and I had to upgrade to a 9.5. But size 9.5 also fits perfectly with orthopedic insoles. I really wish Asics would stop messing around with model after model so much. At the moment they are 20 or 21 years old and they never match from year to year. I spend a lot of time looking for new and new 18s on Revain and Ebay.
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