Understanding Flat Feet (Pes Planus)

A Comprehensive Guide to Causes, Symptoms, and Treatment Options

Orthopedics

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Last updated: Mar 24, 2025

What Are Flat Feet?

Flat feet, medically known as pes planus, is a condition where the arches of the feet are flattened, causing the entire sole to contact the ground when standing.

Types of Flat Feet

  • Flexible flat feet - The arch appears when not bearing weight
  • Rigid flat feet - No arch appears regardless of weight-bearing status
  • Congenital flat feet - Present from birth
  • Acquired flat feet - Develops over time

Common Causes

  • Genetic factors
  • Developmental issues
  • Injury or trauma
  • Aging
  • Pregnancy
  • Obesity
  • Rheumatoid arthritis
  • Diabetes

Symptoms

  • Pain in feet, especially in the heel or arch area
  • Tired or achy feet after standing
  • Lower back pain
  • Ankle swelling
  • Difficulty with certain physical activities
  • Unusual shoe wear patterns

Diagnosis

Physical Examination

  • Visual inspection
  • Footprint analysis
  • Observation of walking pattern

Imaging

  • X-rays
  • CT scans (in complex cases)
  • MRI (if structural problems suspected)

Treatment Options

Conservative Management

  1. Orthotic devices
  2. Supportive footwear
  3. Physical therapy
  4. Weight management
  5. Activity modification

Medical Interventions

  • Anti-inflammatory medications
  • Corticosteroid injections
  • Custom orthotics

Surgical Options

  • Arthrodesis
  • Tendon transfer
  • Osteotomy

Prevention and Self-Care

  • Maintain healthy weight
  • Wear appropriate footwear
  • Regular foot exercises
  • Avoid prolonged standing when possible
  • Early intervention for foot pain

When to See a Doctor

  • Persistent foot pain
  • Increasing difficulty walking
  • Progressive deformity
  • New onset flat feet in adults

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