Flatfeet: Painful and Correctable

There’s an easy way to tell if you have flat feet. Simply wet your feet and stand on a dry surface that will leave an imprint of your foot. A normal footprint has a wide band connecting the ball of the foot to the heel with an indentation on the inner side. A foot with a high arch has a large indentation and a very narrow connecting band. Flat feet leave a nearly complete imprint, with almost no inward curve where the arch should be.

In many adults, a low arch or a flatfoot is painless and causes no problems. However, a painful flatfoot can be a sign of a congenital abnormality or an injury to the muscles and tendons of the foot. If the condition progresses, you may experience problems with walking, climbing stairs and wearing shoes.

See your doctor if:

• Your feet tire easily or become painful with prolonged standing.
• It’s difficult to move your heel or midfoot around, or to stand on your toes.
• Your foot aches, particularly in the heel or arch area, with swelling along the inner side.
• Pain in your feet reduces your ability to participate in sports.
• You’ve been diagnosed with rheumatoid arthritis; about half of all people with rheumatoid arthritis develop a progressive flatfoot deformity.

Diagnosing Flatfeet

A doctor needs to identify why the flatfoot developed. Possible causes include congenital abnormality, a bone fracture or dislocation, a torn or stretched tendon, arthritis, or neurologic weakness.

Be sure to wear your regular shoes to the examination; an irregular wear pattern is another indicator of acquired adult flatfeet. Your physician may request x-rays to see how the bones of your feet align.

Treatment Options

Treatment options depend on the cause and progression of the flatfoot. Conservative treatment options include:

• Making shoe modifications and using orthotic devices such as arch supports and custom-made orthoses

• Taking non-steroidal anti-inflammatory drugs, such as ibuprofen, to relieve pain

• Using a short-leg walking cast or wearing a brace

• Injecting a corticosteroid into the joint to relieve pain

• Rest and ice

• Physical therapy

In some cases, surgery is needed to correct the problem. Surgical procedures can help reduce pain and improve bone alignment. Types of surgery your orthopaedist may discuss with you include:

• Arthrodesis, or welding (fusing) one or more of the bones in the foot/ankle together

• Osteotomy, or cutting and reshaping a bone to correct alignment

• Excision, or removing a bone or bone spur

• Synovectomy, or cleaning the sheath covering a tendon

• Tendon transfer, or using a piece of one tendon to lengthen or replace another

Flat feet are a serious matter. If you are experiencing foot pain and think it is related to flat feet, talk to your orthopaedist.