Flat Foot - Causes, Symptoms & Treatment
A flat foot is a common foot deformity in which the inner arch of the foot is reduced or absent. It can cause pain in the foot, knee, and back.
Things worth knowing about "Flat foot"
A flat foot is a common foot deformity in which the inner arch of the foot is reduced or absent. It can cause pain in the foot, knee, and back.
What is a Flat Foot?
A flat foot (medically known as Pes planus) is a common foot deformity in which the inner longitudinal arch of the foot is flattened or completely absent. Normally, the inner side of the foot forms a visible arch when standing. In people with flat feet, this arch is reduced or missing, causing a larger area of the sole to make contact with the ground during standing and walking.
Flat feet can affect one or both feet and occur in people of all ages. In young children, flat feet are generally normal and the arch typically develops naturally by school age.
Causes
There are several possible causes of flat feet:
- Congenital deformity: Some people are born with a flat arch.
- Muscle weakness: Weakness in the foot and lower leg muscles may fail to support the arch adequately.
- Excess body weight: Increased body weight places greater stress on the arch over time.
- Aging: Ligaments and tendons may weaken with advancing age.
- Injuries: Damage to tendons (e.g., the posterior tibial tendon) or ligaments can cause the arch to collapse.
- Underlying conditions: Rheumatoid arthritis, diabetes, or neurological disorders can contribute to flat feet.
- Inappropriate footwear: Prolonged use of unsupportive shoes may weaken foot muscles over time.
Symptoms
Many people with flat feet experience no discomfort. However, in more pronounced cases, the following symptoms may occur:
- Pain and fatigue in the foot, especially along the inner side and heel
- Pain in the ankle, knee, hip, or lower back due to altered load distribution
- Swelling along the inner side of the foot
- Rapid fatigue during prolonged standing or walking
- Altered gait pattern (overpronation: the arch rolls inward during walking)
- Pressure sores or calluses in unusual areas of the sole
Diagnosis
Flat feet are typically diagnosed through a clinical examination. The doctor observes the foot while the patient stands, walks, and sits. Common diagnostic methods include:
- Visual assessment: Evaluation of the arch while standing and walking
- Foot pressure measurement (pedobarography): Analysis of pressure distribution across the sole
- X-ray: Used when needed to assess the bones and severity of the deformity
- MRI (Magnetic Resonance Imaging): Indicated when tendon damage or other structural changes are suspected
Treatment
Treatment depends on the severity of the deformity and the presence of symptoms:
Conservative Treatment
- Orthotics: Custom-made orthopedic insoles can support the arch and relieve pain.
- Physiotherapy: Targeted strengthening of foot and calf muscles along with stretching exercises helps stabilize the arch.
- Appropriate footwear: Shoes with good stability and arch support are strongly recommended.
- Weight management: In cases of excess body weight, losing weight can significantly reduce symptoms.
- Pain relief medication: Anti-inflammatory drugs (e.g., ibuprofen) or analgesics may be used for acute pain.
Surgical Treatment
In severe cases where conservative measures provide insufficient relief, surgical intervention may be necessary. Possible procedures include tendon transfers, bone osteotomies, or the insertion of implants to support the arch.
Prevention
The following measures can help prevent overloading of the foot arch:
- Regular strengthening of foot and leg muscles
- Wearing well-fitting, supportive footwear
- Walking barefoot on natural surfaces to promote foot muscle development
- Maintaining a healthy body weight
- Seeking early treatment at the first signs of discomfort
References
- Staheli, L. T. (1999): Planovalgus foot deformity. In: Journal of the American Academy of Orthopaedic Surgeons, 7(4), 253-260.
- German Institute for Medical Documentation and Information (DIMDI): ICD-10-GM, Classification of foot deformities (M21, Q66).
- Pfeffer, G. et al. (1999): Comparison of custom and prefabricated orthoses in the initial treatment of proximal plantar fasciitis. Foot & Ankle International, 20(4), 214-221.
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