Archive for category Foot Pain

PODIATRY DOCTORS

Dec 29

Posted by efootpain in Foot Pain, Medicine, Podiatrist Training | No Comments

Podiatry Doctors, or Doctors of Podiatric Medicine, (or Podiatrists), are physicians specializing in the diagnosis and treatment of the foot and ankle. They are Physicians and Surgeons of the foot, with their scope of practice limited to the lower leg (in some states), the foot and ankle. Their training consists of 4 years of medical school after college, and extensive internship and residency training after graduating from medical school. Post-doctorate training will establish their credentials and surgical proficiency, similar to any medical specialty. Podiatrists, as with all medical professionals, are licensed by each state.

Common foot ailments treated by Podiatry Doctors (Podiatrists) are corns, calluses, ingrown toenails, heel and pain, warts, generalized foot and ankle pain and bunions. Diabetics greatly seek the help of Podiatrists to assist in proper toenail trimming and prevention of open wounds and ulcers. Generalized foot pain if often treated by Podiatrists with custom insoles for shoes, or “orthotics”.

Podiatrists fill a specialized niche in our society – treating and alleviating foot pain. They have been specifically trained to assist in determining the causes and treatment of chronic foot pain, thus offering the public the relief necessary to obtain a fulfilling and pain free lifestyle.

Tags: common foot ailments, diabetics, foot and ankle pain, Orthotics

Ingrown Toenails

Dec 26

Posted by efootpain in Foot Pain, Ingrown Toenail, Ingrown Toenails, Ingrown Toenails, Medicine, Toe Pain | No Comments

Author – Gary F Ochwat DPM

Ingrown toenails are a common foot condition in which the nail is curved downward and the side of the toenail grows into the flesh of the toe. This irritates the skin creating pain and redness and sometimes leads to infection.

Common causes of ingrown toenails include hereditary, trauma improper trimming and tight fitting shoes. Toenail fungus may also cause the nail to become ingrown.

Prevent ingrown toenails by trimming your toenails properly. Cut the nails straight across and do not cut them too short. Avoid wearing tight fitting shoes. It is a myth that cutting a “V” in the nail allows the nail to grow straight. This is simply not true. The toenail will continue to grow curved downward.

Self care treatment includes soaking the toe in warm water for 15-20 minutes and apply a topical antibiotic ointment twice a day. When an infection is present, seek professional care from a Podiatrist. This is especially true for those at risk because of diabetes or vascular disease. Often a minor procedure is performed to permanently remove the ingrown side of the toenail. This is a common, painless treatment procedure performed under local anesthesia in the Podiatrist’s office.

Tags: diabetes, Ingrown Toenails, podiatrist, professional care, self care, tight fitting shoes, trauma

Arch Pain

Dec 21

Posted by efootpain in Arch Pain, Arch Pain, Causes & Symptoms, Foot Pain, Medicine, Plantar Fasciitis | No Comments

Arch pain is a treatable, but chronic condition of the foot that most often occurs from Plantar Fasciitis. This very common condition is the result of inflammation of a ligament in the bottom (plantar) aspect of the foot. The ligament attaches from the inferior aspect of the heel bone (calcaneous) to the inferior aspect of the toes (phalanges).

Symptoms:

- Pain upon waking with the first few steps or after prolonged sitting.
- Inability to tolerate flat shoes or walking barefoot
- A sharp trigger point pain in one or both heels, may cause limping

Causes:

- Flat or high arched foot structure
- Prolonged standing
- Working on very hard surfaces
- Very common among runners
- Associated heel spurs

Differentials:

- Calcaneal (heel bone) stress fracture
- Plantar Fascia partial tear or rupture
- Plantar Fibromas
- Bone cysts
- Foot strain

Evaluation – At your appointment, your doctor will perform a history and physical, take x-rays to rule out causes for your heel or arch pain, beside plantar fasciitis. Be prepared to ask questions about your condition and give details about your habits including work conditions, exercise activities and typical choices for shoe gear. Be prepared to discuss when the pain occurs and what makes it worse or feel better, this will help make an accurate diagnosis.

Treatment – There are many treatment options available, but it is important to remember that this tends to be a chronic foot structure related condition. A person once prone to this condition can see a return of the pain if activities that trigger it are prolonged. Treatment options include:

- Physical therapy, stretching and icing
- Orthotics
- Cortisone injections
- Shoe gear modification to supportive shoes

Most cases will respond to conservative care, but there are surgical options available for those cases that do not respond. This includes resection of associated heel spurs and shock wave therapy.

Tags: accurate diagnosis, bone cysts, bone stress, chronic foot, conservative care, cortisone injections, diagnosis treatment, foot strain, heel spurs, Plantar Fasciitis, stress fracture, supportive shoes

Foot Blisters

Dec 19

Posted by efootpain in Foot Blister, Foot Blister, Foot Pain, General, Medicine | 1 Comment

Foot blisters are common pathology in our active society. Blisters occur due to skin friction or abrasion in the foot or ankle. The body produces fluid beneath the skin and increases in size leading to pain, irritation, and sometimes infection. Blisters can be seen from people wearing ill-fitting shoes, not wearing proper hosiery, athletes prone to over training or “breaking in” new shoes, sweaty feet, allergic reactions, diabetic patients with neuropathic disease, and excessive sandal use. The foot blisters can cause significant symptoms of redness, soreness, large fluid filled “bubbles”, and can lead to more serious problems as ulcerations and infection.

Foot blisters can be prevented and treated by a podiatrist. Keep the feet dry with foot powder and changing socks/ hosiery to reduce moisture. Make sure to “break in” a shoe or custom orthotic to reduce the friction applied from the new device. Smaller blisters may be treated with soaks, topical antibiotic, and bandages. Larger blisters may have to be drained to reduce the fluid pressures and pain in the foot. This may require a visit to a professional podiatrist to reduce risk of infection and ulceration. The podiatrist may prescribe a topical and/or oral antibiotic, soaking regime, custom orthotic to reduce reoccurrence, proper hosiery, and shoe recommendations.

Tags: diabetic patients, fluid pressures, foot blisters, ill fitting shoes, new shoes, pain in the foot, shoe recommendations, skin friction, sweaty feet, ulcerations

Diabetic Foot

Dec 13

Posted by efootpain in Callus, Corns, Diabetic Foot, Diabetic Foot Care, Diabetic Foot Complications, Foot Care, Foot Treatment, Medicine | No Comments

Diabetic foot disease is an unfortunate complication in patients with diabetes. Diabetes Mellitus (DM) is a disease where the body is unable to produce an adequate amount of insulin. This reduction in insulin leads to an increase in blood sugar in the body that may lead to many complications associated with diabetes. The diabetic feet complications are one of the unfortunate areas affected by this disease.

Patients with diabetes mellitus may have poor circulation, loss of feeling or peripheral neuropathy in the hands and feet, thickened toenails, hardened calluses, ulcerations or sores on the bottom or top of the feet, and increase risk of amputation. In addition, the diabetic foot patient may be imbalanced leading to biomechanical deformities as bunions, hammertoes, collapsed mid-foot arch, equines or tight heel cord, and charcot

Neuroarthropathy.

The diabetic foot should be evaluated and treated by a professional podiatrist. The clinical exam is important to evaluate the skin texture, toenails, pulses for circulation, testing for nerve damage, muscle strength weakness, biomechanical stability, and gait testing. Diagnostic tests as x-rays, diagnostic ultrasound, Doppler studies, nerve tests, blood tests, wound cultures, and MRI or CT scans are other exams used to help the podiatrist gain accuracy in the diabetic foot patient.

Treatment of the diabetic foot is a team effort. It is very important to communicate with the medical doctor, endocrinologist, therapist, dietician, pedorthist shoe maker, and podiatric surgeon. Education is the most important factor in foot health. In order to maintain and reduce complications of the diabetic feet, the patient should begin by following these simple instructions:

Take care of the blood sugar and keep it within control.
Examine and clean your feet daily.
Wear the proper shoes and custom inserts recommended by your podiatrist.
Protect the diabetic foot from extreme temperatures of the different seasons.
Continue with proper exercise to improve blood flow and reduce sugar levels.
Maintain diabetic foot appointments with the podiatrist for check-up.

Tags: diabetes mellitus, diabetic foot disease, patient treatment, peripheral neuropathy, poor circulation

Diabetic foot Care

Dec 10

Posted by efootpain in Callus, Corns, Diabetic Foot Care, Foot Pain, Foot Treatment, Fungus Toenails, Medicine | No Comments

Diabetic foot care is an important factor in the overall health care of a diabetic patient. Podiatrists help reduce the risk factors of diabetic patients that may lead to many debilitating complications. These complications include mild conditions as fungal toenails, ingrown toenails, calluses, corns, and small fissures or cuts in the foot. More severe problems include soft tissue and bone infections, foot ulcerations, leg venous ulcerations, and amputation of the toes or feet.

Diabetic foot care is recommended by Northwest podiatry centers as preventative treatment for long term care of the foot and ankles. Podiatrists treatment involve debridement of painful and thick fungal toenails, debridement of callous tissue that are pre-ulcerative, fitting of special diabetic shoes and inserts, x-rays and diagnostic ultrasound studies to review the proper biomechanical structures of the feet. Diabetic patients must follow the foot care treatment protocol recommended by their podiatrist to enjoy the benefits of overall medical health.

Tags: bone infections, Diabetic Foot Care, diabetic patients, diabetic shoes, preventative treatment, treatment protocol

Podiatrist

Dec 7

Posted by efootpain in Board Certified Podiatrist, Foot Pain, Foot Treatment, Medicine, Podiatrist Medical Education, Podiatrist Medical School, Podiatrist Training | No Comments

A Podiatrist is a specialist in the medical, biomechanical, and surgical treatment of diseases in the foot and ankle. In the United States, the podiatrist is licensed as a Doctor of Podiatric Medicine or D.P.M. Training of a podiatrist requires attendance in a four year Podiatry Medical School program. In addition, further training of up to 2 to 3 years of residency training in an accredited hospital or university institution. Many podiatry medical schools are affiliated with medical school programs. There are approximately eight podiatric medical schools in the United States. They are located in California, Arizona, Iowa, Ohio, Illinois, Florida, Pennsylvania, and New York.

Entrance into a college of podiatric medicine requires at least 90 semester hours of college credit at an accredited institution. The actual minimum semester credit hour requirements for all colleges of podiatric medicine include the following prerequisites according the American association of Colleges of Podiatric Medicine. These courses include biology, chemistry, organic chemistry, physics, and English. Most of these courses require between 8 to 12 semester hours depending on the podiatric medical school with laboratory courses included.

The podiatrist medical education is focused on the medical, biomechanical, and surgical aspects of treatment of the foot and ankle. Rotations in various specialties are integrated with their training including vascular surgery, family medicine, internal medicine, radiology, pathology, anesthesiology, emergency medicine, general surgery, orthopedic surgery, psychology, endocrinology, plastic surgery, and neurology. By learning all aspects of human body the podiatrist is well suited to recognize medical symptoms vital to obtaining the correct diagnosis and treatment regime.

Podiatrists are licensed in all 50 states, the District of Columbia, and Puerto Rico. Podiatrists practice in individual or group practices. Hospital and surgical center affiliation and credentialing may be obtained in order for the podiatrist to perform medical and surgical procedures. In addition, podiatrists may also work with HMOs, PPOs, Extended care facilities, health professional schools, Veterans affairs departments, Municipal health departments, and the Public health service department.

Podiatrists strive to become board certified in their specialty that are classified under board certified in primary podiatric medicine and biomechanics, podiatric foot surgery, podiatric reconstructive rear foot surgery, and diabetes prevention and treatment of the diabetic foot wounds and foot wear. Podiatric board certification requires the graduation from an accredited podiatric medical school, completion of an approved podiatry residency, practice experience by years, case submissions, and passing a written, computer based, and oral examination. In addition, CME (continuing medical education) is essential and mandatory in many states in which podiatrists are required to obtain up to 50 hours of education a year to expand their knowledge and learn new techniques.

Podiatrists treat a vast array of medical problems in their daily practice. Many podiatrists work in the office or clinic, hospital, and surgical setting. They treat patients with pathology as heel pain (plantar fasciitis), ingrown toenail infection, onychomycosis (fungal nails), dry skin, athletes foot, fractures of the foot or ankle, plantars warts, flatfeet, tendon ruptures and tendonitis, arthritis, gout, neuroma (Mortons neuroma), soft tissue masses, running injuries, varicose veins, nerve disorders (as tarsal tunnel syndrome), hammertoes (corns and calluses), bunions, tailors bunions (bunionettes), diabetic foot care and ulcerations, pediatric heel pain, cellulites.

The podiatric patient may not only have foot and ankle pathology but also related medical diseases as diabetes, parkinson’s disease, fibromyalgia, multiple sclerosis that may contribute to the foot and ankle disease and requires a team of other medical specialties for complete health care. The team approach in the care of the medical patient may require consultations or treatment by internal medicine, vascular, endocrinology, eye doctors, neurologists, physical therapists, dieticians, and many other specialties depending on the diagnosis.

Podiatrists not only treat patients medically but also surgically when indicated.

They use a vast array of surgical equipment as surgical screws and plates called internal fixation, external fixation devices as mini and large ring fixators, bone grafts, skin grafts, joint implants for the toes, ankles, or subtalar joint, arthroscopy equipment,

And Endoscopy equipment. There are continuing innovations medical and surgical field for the care of the podiatric patient.

Diagnostic tests are also ordered by the podiatrist in order to obtain the most accurate diagnosis. Some equipment may be in the office as the X-ray, diagnostic ultrasound, tuning fork, vascular testing equipment, and neurological testing equipment. Other tests ordered may be performed at other facilities as the CT scan, MRI, flouroscan, bone scan, blood work, and some vascular and neurological exams. These diagnostic measurements are important in the diagnosis of the podiatric patient.

The podiatrist treatment regime may consist of performing conservative care or surgical care. The podiatrist is able to prescribe medications, perform manipulations of the foot and ankle, casting for broken bones, casting for custom orthotics, injections, physical therapy, debridement of tissue and toenails. The podiatrist surgical care is also well rounded that may include ingrown toenail surgery, wart removal, bunion, hammertoes, diabetic debridement, amputations, external fixation devices, fracture and dislocation repair, reconstructive foot and ankle surgery, ankle arthroscopy. The podiatrist is a well rounded medical professional and is important in the health care effort in providing patients with long term health and activity.

Tags: college of podiatric medicine, doctor of podiatric medicine, podiatrist

Best Podiatrist

Dec 2

Posted by efootpain in Board Certified Podiatrist, Foot Pain | No Comments

What is the best podiatrist? The following information will give you a synopsis of what to look forward in finding the best podiatrist in your area. The first source of information that is important in finding the best podiatrist is determining their undergraduate education, the college of podiatric medicine attended, and the number of years of training received in residency and / or fellowship. Another source of information that is important is to determine the board certification status. A podiatrist can become board qualified in forefoot and rearfoot and ankle surgery or just board qualified in forefoot surgery depending on passing a written examination.

After board qualification status is achieved, a podiatrist will have up to seven years to submit surgical cases for review and approval in order to sit and take the oral examination. If passed, the podiatrist will become board certified in either forefoot surgery or rearfoot and ankle surgery or both. A podiatrist will continue on a yearly basis for licensure approval where he or she will need to obtain continuing medical education hours in order to renew their license. Therefore; the best podiatrist is one that is board certified and is very experienced in their field of expertise.

Ankle

Nov 24

Posted by efootpain in Ankle Bone, Ankle Fracture, Ankle Injury, Ankle Pain, Ankle Sprain, Ankle Sprain Treatment, Exercises, Foot Treatment, Glossary | No Comments

The ankle is a ginglymus joint that connects the foot to the lower leg and that helps propel the body through the gait cycle. The ankle joint is also known as the talocrural joint which aids in stability, shock absorption, and proprioception. The ankle joint is a crucial weight-bearing joint which allows the foot to move up and down upon the lower leg. (The side to side motion of the foot is primarily provided by the subtalar joint which is located just below the ankle joint).

The ankle is made up of a very complex anatomic network of bones and soft tissue structures. The ankle comprises of three bones. Two of the bones are located in the lower leg called the tibia and fibula, and one bone is located in the foot called the talus. There are two bony prominences that are felt on the inside and outside of the ankle joint which are called the medial malleolus and lateral malleolus. The medial malleolus is a direct extension of the tibia and is located and felt on the inside of the foot. The bony prominence located on the outside of the ankle is called the lateral malleolus and it is a continuation of the fibula. There are three articular facets located within the ankle joint, which are made up of cartilage that allows range of motion within the joint.

The soft tissue structural anatomy is made up of the ankle joint capsule, syndesmosis, and ligaments. The ankle joint capsule harbors synovial fluid within the ankle joint to allow range of motion within the joint. The syndesmosis is located just above the ankle joint line and is made up of the anterior inferior tibiofibular, posterior inferior tibiofibular, and interosseous ligaments as well as the interosseous membrane. These soft tissue structures contribute to the stability of the ankle.

The ligamentous structures that help hold the bones of the ankle joint together are divided into two categories called the lateral collateral ligaments and the medial collateral ligaments. The lateral collateral ligaments are comprised of the anterior talofibular, calcaneofibular, and posterior talofibular ligaments. The medial collateral ligaments, also called the deltoid ligaments, are divided into superficial and deep portions. The superficial deltoid ligaments are made up of the tibionavicular, calcaneotibial, and superficial posterior talotibial ligaments. The deep deltoid ligaments are made up of the anterior talotibial and deep posterior talotibial ligaments. These ankle joint ligaments are very durable, but not completely resistant to injuries.

The most common injuries seen in the ankle joint are sprains, ligament ruptures, and bone fractures. These injuries can be treated with or without surgery. If these injuries are not treated properly, they can lead to arthritis within the ankle joint.

Ankle sprains are the most common injuries that are seen in emergency rooms at the hospitals. Ankle sprains occur when there is a sudden twist or rotation of the foot upon the lower leg. This puts strain on the ligaments of the ankle joint which can cause different types of structural problems. An ankle sprain occurs when the ligaments of the ankle become overstretched or even partially torn during excessive motion. If the sprain or excessive motion is great enough, the ligament or ligaments can even rupture. An avulsion fracture can occur when the ligament does not rupture, but the bone breaks with the ligament still attached. These problems are very different and are treated in different ways.

The most common ankle sprain that occurs is when the foot falls inward, called an inversion ankle sprain. This direction of excessive motion usually damages the lateral collateral ligaments of the ankle and the pain is located on the outside of the ankle. The first and most common ankle ligament that gets damaged is the anterior talofibular ligament. When the sprain is greater, it can cause damage to the calcaneofibular ligament or even more severe, the posterior talofibular ligament.

Another type of ankle sprain is called an eversion ankle sprain. Here, the foot falls outward. This can lead to pain on the inside part of the ankle. The superficial deltoid and sometimes deep deltoid ligament can become injured depending on the severity of the sprain.

Ankle sprains are commonly treated without surgery. The conservative treatment follows the pneumonic PRICE. The P stands for protection, the R for rest, the I for ice, the C for compression, and the E for elevation. Protection can consist of a cast, or a walking boot. Rest is important to allow the sprained ligaments to heal. Ice is important to decrease the inflammation that occurs during the healing process of the sprain. Compression is equally important to reduce the swelling. Elevation also reduces the swelling that occurs during the healing process. The process can take up to 3-5 weeks depending on the severity of the injury, followed by a rigorous physical therapy regiment.

Surgery is indicated when the pain has not been resolved in a reasonable period of time, or when the ligaments are ruptured, or when there is a loss of ankle stability. Some surgeries involve direct primary repair of the ruptured ligament or ligaments. Tendon transfers, tendon grafts, and rerouting of ligaments can be used when a direct repair is not enough to stabilize the ankle. An avulsion type fracture can be repaired with the use of anchors that reattach the tendon to the bone.

When the injury is more severe than an ankle sprain, the articular cartilage within the ankle joint can become damaged. The location of the talus bone within the ankle joint predisposes itself to impaction injuries that occur during a fall from a height or excessive rotation within the ankle joint. When this occurs, the articular cartilage of the talus can become weakened or even fractured. When the cartilage gets weakened, it can form large cyst like lesions called Osteochondral Dessicans. This osteochondral injury to the talus is a very difficult injury to diagnose and is often not seen on radiographs. A Magnetic Resonance Imaging may be required to help diagnose the injury and define the treatment plan.

When an Osteochondral Dessicans or osteochondral lesion occurs, conservative measures do not have very high success rates and surgical intervention is usually required. The surgical treatment of osteochondral defects varies greatly. The main purpose of surgery is to resolve pain which may involve replacing the cartilage that is damaged with healthy cartilage from a different location within the body or from a cadaver.

When an ankle injury occurs at very high velocity, the bones of the ankle can become deformed and lead to fracture. The bones that most commonly break within the ankle are the tibia and fibula. The orientation that the bones break depends on the forces that are applied and the direction in which it occurred in.

An “open” ankle fracture is a serious injury that involves a broken bone within the ankle in the presence of a break in the skin. There is a high chance of infection with an open ankle fracture and so treatment involves multiple procedures and intravenous antibiotics. A “closed” ankle fracture is less serious and is described by any fracture of bones within the ankle in which the skin is still totally intact.

There are many classification systems that are used by surgeons to help guide the treatment of ankle fractures. A common and easy system that is used to describe ankle fracture is the Danis Weber classification, which is based on the location of the fracture within the fibula bone. A Danis Weber A is a fracture on the fibula that is below the ankle joint. A Danis Weber B is a fracture on the fibula that occurs at the ankle joint. Finally, a Danis Weber C is a fracture on the fibula that occurs above the ankle joint.

The management of ankle fractures is determined by the amount of displacement of the fractured bone, any loss of stability within the ankle joint, and if an open fracture is present. Any ankle fracture can have fracture blisters associated with this traumatic event. Fracture blisters can contain blood or serous fluid within the blister which can be treated by draining them or by deroofing the blister and applying a sterile protective bandage.

The nonsurgical treatment is implemented when there is no loss of ankle stability, fracture displacement or breaks in the skin. The nonsurgical management consists of ice, elevation, compression, and immobilization with a below the knee cast.

Surgery is indicated when the ankle fracture is considered “open,” or when there is a loss of stability, or when there is displacement of the fracture bones. Surgery is usually delayed for 7-10 days to reduce the swelling that occurs with ankle fractures. The fractured bones are fixed with screws, plates, K-wires, Steinmann pins, and external fixation devices. The post operative period is determined by the time is takes for healing of the bone and soft tissues.

Another associated disorder that can occur with or without ankle fractures is an injury to the syndesmosis of the ankle joint. The syndesmosis helps control the stability of the ankle joint which is located just above the tibia and fibula articulation. An injury to the syndesmosis displays an excessive amount of space within the ankle joint making it unstable and painful. Surgery is performed to stabilize the syndesmosis and ankle joint by using screws and suture material.

Any injury that occurs within the ankle joint can lead to arthritis with or without the proper treatment. The chances of arthritis forming within the ankle are decreased by the length of time treatment starts and the severity of injury. Arthritis can be displayed within the ankle joint by forming bony exostoses and decreasing ankle joint space leading to decrease range of motion. This can be treated with cortisone injections temporarily or by surgical fusion or total ankle replacement.

Flat Feet

Nov 24

Posted by efootpain in Causes & Symptoms, Devices, Flat Feet, Flat Foot, Foot Pain, Foot Treatment, Glossary, Rigid Flat Feet | No Comments

“Flat Feet” is a widely used generic medical term that describes some type of decrease in the height of the arch that is located on the inside of the foot. In some cases, a person with flat feet has a slight decrease in arch height, while in other cases, there is no arch visualized. Flat feet are considered normal in infancy and in young children until 8-10 years of age. Around this time, an arch should be identified. However; most people with flat feet never develop pain.

There are many different terms that are used to describe a person with flat feet. Some of these include pes planus, pes valgus, equino valgus, collapsing pes valgo planus, and talipes calcaneovalgus. Although flat feet is a broad term, it is a very complex disorder that not only affects the arch but also other parts of the foot and/or ankle. The most commonly associated disorders with flat feet are bunions, hammertoes, heel pain, midfoot collapses and dislocations, and an everted or valgus position of the heel and/ or ankle as well as equinus. Since there are so many associated disorders that can cause symptoms with flat feet, the associated disorders should also be treated concurrently when treating flat feet.

In general, there are two very common presentations of flat feet which are termed “flexible” and “rigid”. A “flexible” flat foot means that the arch collapses upon weight bearing of the foot while the arch of the foot is visible when the foot is not touching the ground. Flexible flat feet commonly occur in the pediatric or adolescence and can continue into adulthood. If symptomatic and not properly treated, a flexible flatfoot can become stiff or rigid and potentially develop in a more severe condition. The second common presentation of flat foot is termed “rigid” which means that the height of the arch is the same whether or not the foot is touching the ground during weight-bearing. Rigid flat feet can be caused by many factors including arthritis, tarsal coalitions, and congenital vertical talus.

The severity of symptoms that occur with flat feet varies from person to person as well as the location on the lower leg and foot. The symptoms are not defined by how low the height of the arch is but rather the adaptive changes in bone, tendons, and ligaments. At times, there are patients that have no visible arch height, who are asymptomatic, while patients with a very slight decrease in their arch height have severe symptoms.

After diagnosing flat feet by a physical examination and radiographs as well as other imaging modalities, the treatment regiment should begin promptly. There are non-surgical and surgical treatment protocols to help treat the pediatric as well as the adult acquired flat foot. The conservative treatments are based on controlling the pathological movements of the bones, ligaments, and tendons. This is done by custom molded foot orthotics, and/ or foot and ankle braces. Rest, ice, compression, elevation and an organized physical therapy regiment helps decrease the tenderness, inflammation, and swelling that occurs.

When considerable effort of conservative treatment has failed to relieve symptoms, surgical intervention is indicated. The type of procedure that is performed is highly variable because each flat foot is unique to each other. The principles behind the vast array of surgical procedures available are based on to correct each area of soft tissue, ligament, and bone that is contributing to the pathologic symptoms. The surgical procedures can range from implants, soft tissue releases, and tendon transfers to osteotomies and fusions of bones with or without bone grafts. The recovery period is dependent on the surgical procedure performed which can range from 8- 12 weeks followed by physical therapy.