High Arch Deformity/Pes Cavus

High arch (cavus foot) is a condition in which the arch on the bottom of the foot that runs from the toes to the heel is raised more than normal. Because of this high arch, excessive weight falls on the ball and heel of the foot when walking or standing causing pain and instability. Children with neurological disorders or other conditions such as cerebral palsy, spina bifida, poliomyelitis, muscular dystrophy are more likely to develop cavus foot.  It may sometimes occur as an inherited abnormality.

The symptoms of cavus foot include one or more of the following:

  • Pain in the foot while walking, standing and running
  • Heel is tilted inwards leading to instability of the foot and ankle sprains
  • Callus formation on the ball and at outer edges of the foot
  • Toes become bent (hammertoes) or clenched like a fist (claw toes)
  • Difficulty in wearing shoes
  • Foot length is shortened

Diagnosis of cavus foot is based on the family history and physical examination of the foot. X-ray of the feet may also be ordered to determine the condition.

Treatment

High arches that are flexible do not require any treatment. In cases where there is pain, shoe modifications such as an arch insert or support insole can help to relieve pain during walking. Custom orthotic devices can be given that fit into the shoe and provide stability and cushioning effect. Your doctor may recommend a brace to help keep the foot and ankle stable. In severe cases, surgery is performed to flatten the foot. Any coexisting nerve disorders are also treated.



BOFAS European Foot and ankle society