Cushions ball of foot or offloads metatarsal heads depending whether you put pad directly on top of ball of foot or behind ball of foot. If you don't have a Podiatrist and using the Regular Thickness for general cushioning for standing long hours or any cushioning you can place them directly ON the painful area. This applies only to REGULAR thickness. For the extra thick it can be placed directly on the ball of the foot but many doctors may direct you to place it behind. 2 different thickness choices ensures for a comfortable fit