Flat Feet: Causes, Symptoms, Treatment and Cost

Flat feet, also termed as pes planus or fallen arches, are a condition in which the whole sole of the foot makes contact with the ground while standing. It can occur in one or both feet.

• Rigid Flat Feet: This is a condition in which the arch of the foot is entirely flat and does not move when the foot is pressed against the ground.
• Flexible Flat Feet: This is a condition in which the foot arch flattens only when weight is placed on it. The arch then returns to its normal shape once weight is removed.
• Congenital Flat Feet: This type of flat feet occurs from birth and can be caused by genetic factors, neuromuscular disorders, or other medical conditions.

• Flat feet may be caused by hereditary characteristics.
• It may also be caused by a number of medical disorders, including diabetes, obesity, and nerve damage.
• Muscle weakness or tight tendons in the feet can cause the arches of the foot to collapse.
• Wearing shoes with improper support may be a factor.
• Age-related changes in the foot structure which may lead to flatfoot deformities.

• Having pain in the feet, ankles, or knees.
• Unstable gait and difficulty with walking.
• Swelling of the foot along the inner arch.
• Low arches, or complete lack thereof when standing.
• Difficulty standing on toes.
• Pain in feet with prolonged standing or walking.
• Abnormal rotation of the foot when weight is applied.

• Wear supportive shoes that have good cushioning, arch support and shock absorption.
• Avoid high-heels and walk on flat, shock absorbing surfaces as much as possible.
• Exercise regularly to strengthen the muscles in your feet and ankles (exercises such as toe raises, calf raises and ankle circles).
• Stretch the arches of your foot with towel crunches or tennis ball massages.
• Incorporate balance exercises into your routine to develop strength in your foot muscles.
• Wear custom-made orthotics or insoles that are designed to correct the structural issues of flat feet in order to prevent them getting worse over time if necessary

• Physical Exam: The first step in identifying flat feet is a physical examination. During the exam, your doctor will look for an arch in your foot when you stand, as well as any other signs of flat feet such as swelling or redness.
• X-Rays: X-rays can help determine the structure of the foot by showing the bones and soft tissues. This can help your doctor determine if there is a flattening of the arch or if there is any abnormality in the bone structure that may be causing flat feet.
• CT Scan: A CT scan can provide a more detailed view of the bones and soft tissues than an X-ray. It is used to look for any changes in bone structure that may be causing flat feet, such as misalignment or fractures.
• MRI: An MRI can provide a detailed image of the bones and soft tissues of the foot and ankle, allowing your doctor to see if there are any abnormalities that could be causing flat feet.
• Ultrasound: An ultrasound can provide images of the muscles and tendons in your feet and ankles, allowing your doctor to check for any tears or inflammation that could be contributing to flat feet.

• Pain or fatigue in the feet, ankles, or lower legs.
• Difficulty with walking, running, and sporting activities.
• Poor body postures due to lack of arch support leading to back pain or discomfort in other parts of the body, such as hips and knees.
• Aching or burning sensations along the inside of the foot and ankle when standing for long periods of time.
• Reduced range of motion in the ankle joint due to reduced flexibility and stability resulting in greater difficulty with balance when standing on one leg or uneven surfaces

• Massage your feet with lukewarm sesame oil.
• Exercise your feet, ankles and calves by performing toe stretches throughout the day.
• Avoid regularly wearing high heeled or very flat shoes; look for shoes with a moderate heel and proper arch support.
• Macerate raisins in water overnight, pour off the liquid and drink it twice daily for a few weeks to strengthen muscles of the feet and calves.
• Make a paste using rock salt, ashwagandha (Indian ginseng) powder and sesame oil; apply it to your feet each night before bedtime and wash it off in the morning.
• Place small stones inside your socks while walking or running to increase pressure points on acupressure points in order to improve blood flow and reduce pain from flat feet .

The best diet for someone with flat feet is one that focuses on whole, unprocessed foods that are anti-inflammatory. These include:

• Fruits and vegetables: Consume a range of colourful fruits and vegetables that are high in antioxidants as well as other nutrients.
• Healthy fats: Include healthy fat sources like olive oil, nuts, seeds, avocados, and fatty fish such as salmon.
• Whole grains: For more fibre and nutrients, choose whole grains over processed grains.
• Lean proteins: Include lean proteins such as eggs, poultry, fish, beans, and tofu to get adequate protein without saturated fat.
• Herbs and spices: Use herbs and spices to flavour your food without added salt or sugar.

• Fried food: Fried foods, such as french fries, are high in fat and calorie content, which can cause inflammation and soreness in the feet.
• Sugary food and drinks: Sugar increases inflammation and sends blood sugar levels on a roller coaster. This might result in foot swelling and achiness.
• Dairy products: Milk, cheese, and other dairy items add to excess mucus production which can increase water retention that may cause your feet to become more swollen than normal.
• Alcohol: Excessive alcohol consumption has been linked to foot swelling and pain due to water retention.
• Fast food: Fast food is loaded with calories, salt, fat, sugar - all of which can worsen foot pain by causing inflammation and swelling.

• Orthotics: Non-custom, off-the-shelf arch supports can provide arch support, relieve strain on the pronated foot, reduce pain and improve functionality.
• Heel pads: Properly placed heel pads in a shoe can help redistribute pressure away from painful flat foot areas while improving cushioning and providing better shock absorption.
• Physical therapy: A physical therapist may suggest exercises that strengthen the muscles around the arch of your foot to support it and reduce strain on your feet when walking or standing for long periods of time.
• Shoe modifications: Building up your shoes with an arch support insert or wearing shoes that provide appropriate arch support can help improve the function of your arches and provide relief for flat feet pain symptoms.
• Low Impact Activities: Swimming, biking or using a modern elliptical equipment are all low impact activities that can help reduce pain associated with flat feet.

The best person to consult for flat feet is an orthopaedic specialist or podiatrist (foot doctor). They will assess your condition and prescribe suitable treatments

• Anti-inflammatory medications: Pain and swelling from flat feet may be alleviated by nonsteroidal anti-inflammatory medicines (NSAIDs) like ibuprofen.
• Corticosteroid injections: In some cases, corticosteroid injections into the arch of the foot can help relieve inflammation and relieve symptoms.

Generally, mild cases can recover in as little as 6-8 weeks with appropriate treatment, while more severe cases may require up to 6 months or longer with multiple interventions.

Generally, patients can expect improvement in pain, strength, flexibility and alignment within a few weeks or months.

However, for more severe cases, structural changes may need to be made that can provide long-term relief from symptoms. The outcomes of these treatments may be permanent depending on individual circumstances.

• After treatment, the patient should continue to wear properly fitted and supportive shoes to maintain arch support while walking.
• Look for shoes with padded heels and raised arches; be mindful of sections of the shoe that may cause excessive pressure on parts of the foot.
• To lessen the pain associated with flat feet, you should include stretching and strengthening exercises into your regular routine.
• Make sure to wear insoles or orthotics when necessary for extra cushioning for areas with less padding or extra height for a better gait pattern association with proper alignments; consult a durable medical equipment store about custom-made orthotics for you if needed
• Invest in a good quality foot massager after running or standing throughout the day; this will help ensure circulation and relaxation within all muscles related to arch support

In India, conservative treatments such as orthotic devices may cost between INR 500 and INR 5,000.

Physiotherapy sessions may range from INR 200 to INR 500 each session.

Surgery costs could reach up to INR 75,000 or more depending on the procedure required.

• Pain in feet and legs.
• Swelling and tenderness.
• Bruising of skin.
• Increased risk of infection.
• Muscle weakness in the feet and legs.
• Nerve damage that can cause.
• Lower limbs or the feet may feel numb or tingly.
• Having trouble standing or walking for extended periods of time.
• Reduced balance and coordination.
• Reduced flexibility in the joints.
• Risk of developing arch-related injuries such as plantar fasciitis.

See a doctor in your area if you have flat feet issues since they may lead to problems including 'bad body postures, restricted range of motion, and difficulty walking' and treatment programmes can last anywhere from a few months to years, depending on how severe the condition is.