I have had flat feet forever, but now they hurt every day! What can I do? Millions of Americans have flat to low arched feet and no pain. It is the painful flat foot that should be treated. Flat foot is actually a catch-all term for a variety of complex foot deformities. Only a trained foot and ankle surgeon can determine the severity and "planal dominance" of your flat foot; and proper diagnosis leads to successful outcomes. All flat feet have a similar look, progressive loss of arch height. This can be coupled with toe drift towards the outside of your foot, heel tilt outward, a short Achilles tendon (equinus), and other deformities like bunions and hammertoes.

What causes flat feet? This list could be endless, but for brevity; congenital flat feet (inherited from Mom and Dad) are the most common, but you can develop a flat foot when you are overweight, have rheumatoid arthritis, diabetes, or have been in an accident. Usually flat feet are noticed in early adolescence and progressively worsen as you mature. It is normal for a baby to have a flat foot, but this should resolve by the age of two. Commonly symptoms start at the age of 7 or 8 and worsen with activity. A flexible flat foot is one that looks normal when not bearing any weight, but as soon as you stand the arch collapses to the ground. You could ski without skis!

Symptoms of a flat foot can include pain, burning, calf cramping (Charlie horses), abnormal turning in of the ankle, shin splints, knee, hip and back pain, and often generalized fatigue with activity. In the late stages, the pain increases and the foot stiffens due to arthritis of the joints.
Diagnosis of a flexible flat foot is done by x-ray findings coupled with physical exam and gait analysis. A flat foot can actually be a tendon tear, fracture or other disorder like Charcot neuroarthropathy, so a complete podiatric exam including x-rays should be done to evaluate your condition.

Treatment includes rest, shoe gear modification, an orthotic device to control the abnormal biomechanics, padding, bracing, weight loss, anti-inflammatories or injection therapy to decrease inflammation, immobilization, physical therapy, and at the later stages, surgery.
When is surgery needed for flat feet? If you have pain every day, in every pair of shoes you own (including your athletic shoes) and you have treated your condition with conservative therapy without any relief; it’s time to discuss reconstructive surgery. Surgery should never be contemplated without pain and activity limitations and should always follow extensive conservative therapy. There are many advances in flat foot repair surgery and varied procedures depending on your foot type, the stage of your deformity, your activity level, your medical history, and your age.

Make an appointment to discuss surgery with your podiatrist if you have progressing symptoms. Fear of surgery should not keep you out of the office because 80% of patients who come in asking for surgery should leave with a conservative treatment plan. Call or contact us on the website for an appointment today to get your questions answers. Don’t live with the fatigue, instability and compensatory pain in the rest of your body from your flat feet. There are some very simple answers to most patients’ pain, so contact us for an appointment today.