It doesn't get 5 stars because I'm a harsh grader, and because it doesn't work miracles.  But it has a lot of things going for it.

1) It works.  It makes all kinds of uncomfortable shoes much more bearable, and I can actually wear a bunch of shoes that previously I couldn't last long in.  Obviously this will not make your 4 inch heels feel like sneakers.  But they're better than&nbsp;<a data-hook="product-link-linked" class="a-link-normal" href="/Dr-Scholl-s-For-Her-Insoles-High-Heel-Women-s-Sizes-6-10/dp/B0020I3750/ref=cm_cr_arp_d_rvw_txt?ie=UTF8">Dr. Scholl's For Her Insoles, High Heel, Women's Sizes 6-10</a>.

2) It's hard and there's no sticky bit, so it's easy to transfer from shoe to shoe and also easy to clean (the sticky gel insoles gather all sorts of lint and cat hair).  Now I wear it in all my heels.

I don't know how exactly it works because I have a fairly high arch and the pads don't exactly support the arches all the way, but wear them around for a while and you'll feel the difference.  I actually tried wearing just one of them, and after standing around for about 20 minutes, the side that didn't have it was beginning to ache a bit.  So yes, I can say empirically that it works.

Note: It does make tight shoes tighter, so it doesn't work well for shoes that are already snug. I mostly use it for boots. Can't say how well it works for shoes with no backs, as I received mine without the velcro thingies.