New in box - I took them out once but they didn't fit in the shoes I wanted to use them in. From the manufacturer's site: "Medium cushioning and maximum forefoot comfort. This footbed features a built-in metatarsal pad to support the foot's bones in their natural lift and spread. Built on our super durable EVA base to offer reliable relief from forefoot pain associated with conditions like Morton's neuroma and Metatarsalgia. This insole works great in most medium-fitting shoes like running shoes, casual sneakers, tennis shoes and hiking boots."