Fallen Arch

Prevention

Since most cases of flatfeet are inherited, the condition is hard to prevent. Even when children with flexible flatfeet are treated with arch supports and corrective shoes, there is little evidence that this prevents the condition from lasting into adulthood.

Treatment

For mild pain or aching, try acetaminophen (Tylenol) or a nonsteroidal anti-inflammatory drug (NSAID) such as aspirin or ibuprofen (Advil, Motrin and others).

Flexible Flatfoot When there are no symptoms, treatment is not needed.

If a child older than age 3 develops symptoms, the doctor may prescribe a therapeutic shoe insert made from a mold of the child's foot or a corrective shoe. As an alternative, some doctors recommend store-bought arch supports. These appear to work as well as more expensive treatments in many children. With any conservative, nonsurgical treatment, the goal is to relieve pain by supporting the arch and correcting any imbalance in the mechanics of the foot.

Surgery typically is offered as a last resort in people with significant pain that is resistant to other therapies.

Rigid Flatfoot The treatment of a rigid flatfoot depends on its cause:

• Congenital vertical talus - At first, some doctors try a procedure called serial casting. The foot is placed in a cast and the cast is changed frequently to reposition the foot gradually. This generally has a low success rate. Most people ultimately need surgery to correct the problem.

• Tarsal coalition - Treatment depends on the age of the person, extent of bone fusion and severity of symptoms. For milder cases, your doctor may recommend nonsurgical treatment with shoe inserts, wrapping of the foot with supportive straps, or temporarily immobilizing the foot in a cast. For more severe cases, surgery is necessary to relieve pain and improve the flexibility of the foot.

• Lateral subtalar dislocation - The goal is to move the dislocated bone back into place as soon as possible. If there is no open wound, the doctor may push the bones back into proper alignment without making an incision; anesthesia is generally provided before this treatment. Once this is accomplished, a short leg cast must be worn for about four weeks to help stabilize the joint permanently. About 15% to 20% of people with lateral subtalar dislocation must be treated with surgery to reposition the dislocated bone.