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Foot Pain and flat feet

 

Definition 
Pes planus or Pronation is a condition where the arch or instep of the foot collapses and comes in contact with the ground. In some individuals, this arch never develops.
Cause
Flat feet are a common condition. In infants and toddlers, the longitudinal arch is not developed and flat feet are normal. The arch develops in childhood, and by adulthood, most people have developed normal arches.
When flat feet persist, the majority are considered variations of normal. Most feet are flexible and an arch appears when the person stands on his or her toes. Stiff, inflexible, or painful flat feet may be associated with other conditions and require attention.
Most flat feet do not cause pain or other problems. Flat feet may be associated with pronation, a leaning inward of the ankle bones toward the center line. Shoes of children who pronate, when placed side by side, will lean towards each other (after they have been worn long enough for the foot position to remodel their shape).
Foot pain, ankle pain, or lower leg pain (especially in children) may be a result of flat feet and should be evaluated by a Podiatrist. Common foot pains that are a result of flat feet are heel pain, Arch pain and forefoot pain.

 

Heel pain can be caused by Plantar Fasciitis, Bursitis or osteoarthritis. These are common problems and can be treated with the help of Ultrasound therapy, strapping and insoles.

Another common issue resulting from Pronation and poorly fitting footwear is Plantar digital neuromas. These are trapped nerves that cause pain in the toes and forefoot.

 

Symptoms
- Absence of longitudinal arch of foot when standing 
- Foot pain. Knee, hip or lower back pain.
- Heel tilts away from the midline of the body more than usual
Signs and Tests 
Examination of the foot is sufficient for the Podiatrist to make the diagnosis of flat foot. However, the underlying cause must be determined. This involves examination of the lower limbs bony and muscular alignments as well as the Gait (Walking motion.)
Treatment
Orthotic (arch supporting insert in the shoe) can bring relief. Sometimes exercise programs are issued and maybe the only treatment necessary. 
Expectations (prognosis)
Most cases of flat feet are painless and no problems are to be expected. The prognosis of painful flat feet again depends on the cause of the condition. Usually treatment is successful, regardless of the cause.
Complications
Flat feet are not really associated with any complications except pain. But can also cause knee, hip and lower back pain and wear in these joints.

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