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Cavus foot (high arch)

The height of the arch of the foot varies between individuals and those with different racial backgrounds. Some people have a high arched foot and this is sometimes termed a cavus foot.

What causes a cavus foot?

Generally, most people are born with a cavus foot although it can develop with time. If the arch height is increasing and the foot appears to be shortening, then there may be an underlying neurological condition causing the muscles to tighten and effect the foot position.

Will it get worse?

It is unlikely that the position will get worse unless there is a progressive neurological condition. However, the position of the toes and the associated problems may deteriorate.

What are the common symptoms?

• High arch
• Pain / discomfort in the foot, leg or back
• Associated deformities (e.g. hammertoes, retracted toes)
• Corn / callous formation particularly on the ball of the foot or toes
• Difficulty in shoes
• Difficulty in walking
• Stiffness in the foot
• A tendency to ankle sprains / lateral instability

How is it recognised?

Clinical examination and a detailed history allow diagnosis. X-rays help to evaluate the extent of the deformity and any arthritis within the joint. Specialist scans help to evaluate the tendons and joints. A detailed gait analysis can help to diagnose the contributing factors to the cavus foot.

What can I do to reduce the pain?

There are several things that you can do to try and relieve your symptoms:

• Wear good fitting shoes with a deep toe box
• Perform exercises to keep the muscles flexible and strong
• Avoid high heels
• Wear a pad over any prominent deformities
• See a podiatrist

What will a podiatrist do?

If simple measures do not reduce your symptoms, there are other options:

• Advise appropriate shoes
• Advise exercises
• Consider prescribing orthotics
• Consider prescribing a custom made ankle foot orthotic
• Advise on surgery

The way in which your foot loads during walking can place increased stress on the muscles, bones and joints and this can be controlled by special shoe inserts (orthotics). Whilst these are unlikely to resolve established deformity they may help reduce discomfort. Severe cases may need an ankle foot orthosis.

Will this cure the problem?

In many cases, the conservative treatments are sufficient to resolve the symptoms and prevent tendon / ligament damage. However, they will not correct the foot position and there will always be the risk of further problems, especially in more severe cases.

What will happen if I leave this alone?

If there are no symptoms, there may not be any problem. However, if there are symptoms, these may well deteriorate with time.

How can I cure the deformity?

The only effective way of correcting the deformity is to have an operation. However, this is usually extensive surgery with a long recovery period and should only be considered if all of the conservative treatments have failed. This is rarely necessary except for the most severe cases.