I've been wearing these shoes with orthopedic insoles for 10 years and I've changed them for new ones. Get a roomy fit. These are the only shoes I can wear due to arthritis in my toes. I'm about to have a fusion, but these shoes have given me a relatively pain-free life for years that I wouldn't have had without surgery. Without her, I would have had to have surgery many years ago. I have tried other shoes worth over $1000 and none of them fit. Only these shoes kept me afloat. Well made and comfortable.