What Are Flat Feet?
If you look at an adult foot from the inside, you'll usually notice an upward curve in the middle. This is called an arch. Tendons -- tight bands that attach at the heel and foot bones -- form the arch. Several tendons in your foot and lower leg work together to form the arches in your foot.
When the tendons all pull the proper amount, then your foot forms a moderate, normal arch. When tendons do not pull together properly, there is little or no arch. This is called flat foot or fallen arch.
How to Check If You Have Flat Feet
You can easily test yourself to see if you might have fallen arches or flat feet. Follow these three steps:
- Get your feet wet.
- Stand on a flat surface where your footprint will show, such as on a concrete walkway.
- Step away and look at the prints. If you see complete imprints of the bottom of your feet on the surface, then you likely have flat feet.
Many young children have flat feet, a condition referred to as flexible flat feet. When the child stands, the feet look flat. But when the child rises to their toes, a slight arch appears. In most cases, as children grow older, the arches develop.
What Causes Flat Feet and Fallen Arches?
Flat feet in adults can arise from a variety of causes. Here are the most common:
- An abnormality that is present from birth
- Stretched or torn tendons
- Damage or inflammation of the posterior tibial tendon (PTT), which connects from your lower leg, along your ankle, to the middle of the arch
- Broken or dislocated bones
- Some health conditions, such as rheumatoid arthritis
- Nerve problems
Other factors that can increase your risk include:
Flat Feet Symptoms
Many people have flat feet -- and notice no problems and require no treatment. But you may experience the following symptoms:
- Feet tire easily
- Painful or achy feet, especially in the areas of the arches and heels
- The inside bottoms of your feet become swollen
- Foot movement, such as standing on your toes, is difficult
- Back and leg pain
If you notice any of these symptoms, it's time for a trip to the doctor.
Diagnosing Flat Feet and Fallen Arches
Your doctor examines your feet to determine two things:
- Whether you have flat feet
- The cause(s)
An exam may include these steps:
- Checking your health history for evidence of illnesses or injuries that could be linked to flat feet or fallen arches
- Looking at the soles of your shoes for unusual wear patterns
- Observing the feet and legs as you stand and do simple movements, such as rising up on your toes
- Testing the strength of muscles and tendons, including other tendons in the feet and legs, such as the Achilles tendon or the posterior tibial tendon
- Taking X-rays or an MRI of your feet
How to Fix Flat Feet
Treatment for flat feet and fallen arches depends on the severity and cause of the problem. If flat feet cause no pain or other difficulties, then treatment is probably not needed. In other cases, your doctor may suggest one or more of these treatments:
- Rest and ice to relieve pain and reduce swelling
- Stretching exercises
- Pain relief medications, such as nonsteroidal anti-inflammatories
- Physical therapy
- Orthotic devices, shoe modifications, braces, or casts
- Injected medications to reduce inflammation, such as corticosteroids
If pain or foot damage is severe, your doctor may recommend surgery. Procedures include the following:
- Fusing foot or ankle bones together (arthrodesis)
- Removing bones or bony growths -- also called spurs (excision)
- Cutting or changing the shape of the bone (osteotomy)
- Cleaning the tendons' protective coverings (synovectomy)
- Adding tendon from other parts of your body to tendons in your foot to help balance the "pull" of the tendons and form an arch (tendon transfer)
- Grafting bone to your foot to make the arch rise more naturally (lateral column lengthening)
Home Remedies for Flat Feet and Fallen Arches
There are home remedies to prevent or manage pain from fallen arches or flat feet. Here are some areas to consider:
- Wear footwear or shoe inserts that are appropriate to your activity.
- When pain occurs, try at-home treatment of rest, ice, and over-the-counter nonsteroidal anti-inflammatories, or NSAIDS, such as ibuprofen. Talk to your doctor first if you take any other medicines or have any medical problems.
- Ask your doctor or a physical therapist to show you stretches that can prepare you for feet-intensive activities.
- Limit or treat risk factors that can make fallen arches or flat feet worse, such as diabetes, high blood pressure, and obesity.
- Avoid activities that put excessive stress on your feet, such as running on roads.
- Avoid high-impact sports such as basketball, hockey, soccer, and tennis.
- Know when to get help. When pain is severe or interferes with activities, it's time to see the doctor for a thorough exam and treatment.
Types of Foot Pain
Psoriatic arthritis (PsA) is a mix of a skin disorder (psoriasis) and joint inflammation (arthritis). It's a long-term condition that can run in families. PsA may cause stiffness and throbbing pain in the tendons over your fingers, toes, and other joints.
To treat it:
- For mild cases of PsA, your doctor may recommend a nonsteroidal anti-inflammatory drug (NSAID) to block the chemicals that cause swelling in your joints. You can get this medication at the pharmacy (aspirin, ibuprofen, or naproxen) or with a prescription.
- Try hot and cold therapy. Heat helps blood circulation to lessen stiffness. Cold lowers swelling.
- Manage your stress, which can make your PsA flare.
- For severe cases, you may need more powerful medications. Options include disease-modifying antirheumatic drugs (DMARDs), including biologics, and corticosteroids.
Plantar fasciitis is the most common cause of arch pain. Plantar fasciitis can affect the heel, arch, or both. Treatment is the same regardless of the location. For persistent plantar fasciitis, an injection with a mixture of a steroid and local anesthetic can be helpful.