Flat feet, also known as pes planus, are a common condition where the arch of the foot is lower than normal or collapses when standing. Some people have flat feet without symptoms, while others develop pain, fatigue or difficulty with walking.
Flat feet can be present from childhood or develop later in life.
What causes flat feet?
Flat feet can occur for a number of reasons. Some people have flexible flat feet from a young age, where the arch is present when sitting but flattens when standing. Others may develop flat feet over time due to changes in the tendons, ligaments or joints of the foot.
Common causes include:
Flexible flat feet (often present from childhood)
Tibialis posterior tendon dysfunction
Age-related changes in the foot
Previous injury
Ligament laxity
Inflammatory conditions such as rheumatoid arthritis
Symptoms of flat feet
Symptoms vary depending on the cause and severity, but may include:
Pain along the inside of the foot or ankle
Swelling around the ankle
Flattening of the arch when standing
Foot fatigue or aching with activity
Difficulty standing or walking for long periods
In more advanced cases, pain may also develop on the outer side of the ankle.
Non-surgical treatment
Many patients with flat feet can be managed without surgery. Treatment options may include:
Supportive footwear
Orthotics or insoles
Physiotherapy
Activity modification
Anti-inflammatory measures
These treatments aim to reduce pain and improve function.
When is surgery considered?
Surgery may be considered if symptoms persist despite non-surgical treatment or if the deformity progresses.
The type of surgery depends on the underlying cause and severity. Procedures may include:
Tendon procedures
Realignment (osteotomy)
Joint fusion in more advanced cases
Surgery is tailored to the individual patient and discussed following assessment.
Assessment by a foot and ankle specialist
If you have persistent foot or ankle pain, or notice a change in the shape of your foot, assessment by a specialist can help determine the cause and appropriate treatment.
Mr Edward Dawe is a consultant orthopaedic foot and ankle surgeon who assesses and treats flat feet at clinics in Chichester, Worthing and Haywards Heath.
No. Many people have flat feet without symptoms. Treatment is only required if the condition is causing pain or affecting function.
Can flat feet get worse over time?
In some patients, particularly when related to tendon problems, flat feet can gradually worsen. Early assessment may help guide treatment.
Do orthotics help flat feet?
Orthotics can help support the arch and reduce symptoms in many patients.
What is the difference between flexible and rigid flat feet?
Flexible flat feet have an arch when the foot is not bearing weight, whereas rigid flat feet remain flat at all times and may be associated with underlying joint problems.
When should I see a specialist?
If you have persistent pain, swelling or difficulty with walking, or if the shape of your foot is changing, it may be helpful to seek specialist assessment.