Flat Feet: Causes, Symptoms, Diagnosis, and Treatment Options

Key Takeaways

  • The medial longitudinal arch collapses when the posterior tibial tendon weakens or becomes damaged, causing the entire sole to contact the ground during weight-bearing.
  • Adults typically develop acquired flatfoot between ages 40-60, with women affected 2-4 times more often than men due to hormonal changes and footwear choices.
  • Rigid flatfoot causes constant pain and limited motion, while flexible flatfoot only flattens under weight and may remain painless for decades.
  • Custom orthotic devices can reduce pain by 70-80% in mild to moderate cases, while severe rigid deformities may require triple arthrodesis surgery with 6-month recovery.
  • The "too many toes" sign—seeing more than 1-2 toes from behind when standing—indicates progressive posterior tibial tendon dysfunction requiring prompt treatment.

Flat feet, also known as fallen arches, occur when the arches in the feet are flattened, causing the entire sole to come into contact with the ground. While many people with flat feet experience no discomfort, others may suffer from pain and difficulty with foot movement. In this article, we'll explore the causes, symptoms, diagnosis, and treatment options for flat feet.

What Causes Flat Feet?

Flat feet can develop due to various reasons, including:

  • Congenital abnormalities present from birth

  • Stretched or torn tendons

  • Damage or inflammation of the posterior tibial tendon (PTT)

  • Broken or dislocated bones in the feet

  • Health conditions such as rheumatoid arthritis

  • Nerve problems

Other factors that may increase the risk of developing flat feet include obesity, diabetes, aging, and pregnancy.

Symptoms of Flat Feet

While some people with flat feet may not experience any symptoms, others may notice:

  • Easily tired feet

  • Painful or achy feet, particularly in the arches and heels

  • Swelling on the inside bottoms of the feet

  • Difficulty with foot movements, such as standing on toes

  • Back and leg pain

Flat Feet: Causes, Symptoms, Diagnosis, and Treatment Options

Diagnosing Flat Feet

To diagnose flat feet, your doctor will examine your feet and look for signs of fallen arches. The examination may include:

  • Checking your health history for illnesses or injuries linked to flat feet

  • Observing your feet and legs while standing and performing simple movements

  • Testing the strength of muscles and tendons in your feet and legs

  • Taking X-rays or an MRI of your feet

Treatment Options for Flat Feet

Treatment for flat feet depends on the severity and cause of the condition. If flat feet cause no pain or difficulties, treatment may not be necessary. However, your doctor may recommend one or more of the following:

  • Rest and ice to relieve pain and reduce swelling

  • Stretching exercises

  • Pain relief medications, such as nonsteroidal anti-inflammatories (NSAIDs)

  • Physical therapy

  • Orthotic devices, shoe modifications, braces, or casts

  • Injected medications to reduce inflammation, such as corticosteroids

  • Surgery, in severe cases

Home Remedies for Flat Feet

You can also try home remedies to prevent or manage pain from flat feet:

  • Wear appropriate footwear or shoe inserts for your activity

  • Apply ice and take over-the-counter NSAIDs when pain occurs

  • Perform stretches recommended by your doctor or physical therapist

  • Limit or treat risk factors such as diabetes, high blood pressure, and obesity

  • Avoid high-impact activities that put excessive stress on your feet

Remember to consult your doctor if pain is severe or interferes with your daily activities. They can provide a thorough examination and recommend the best treatment plan for your specific case.

For more information on flat feet and related conditions, visit:

The Bottom Line

Most flatfoot conditions respond well to orthotics and physical therapy when caught early, but progressive tendon dysfunction can lead to permanent deformity if untreated. The key is distinguishing between flexible and rigid types, as treatment approaches differ significantly. If you're experiencing arch pain or noticing changes in your foot shape, Doctronic can help you get a proper evaluation quickly.

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