Information
A high arched foot is a normal variant of foot shape and does not normally need any treatment. However, there are certain occasions where a high arch foot is pathological and warrants investigation or treatment.
Patients who have a high arch foot often complain of ‘metatarsalgia’ or pain in the ball of their foot. They may also develop secondary clawing of their toes, or be more likely to have ankle sprains.
Neuromuscular conditions can affect the muscle balance in a foot leading to a Cavus deformity. This can be bilateral (such as seen in Charcot-Marie-Tooth (Hereditary Motor and Sensory Neuropathy) or unilateral (eg following a Stroke). The deformity can develop in any patient with a neurological condition.
In some the deformity can progress as the muscle weakness deteriorates, others will be stable. In the majority of patients with pes cavus the treatment will be non-surgical – with insoles, ankle brace, footwear modifications and physiotherapy being the main treatment options, but in some surgery will be considered.
As the pes cavus deformity will develop in certain neurological conditions it may be the first sign of such as condition developing. As a result, any developing cavus foot should be investigated, particularly if unilateral.
M.A. & J. McK. 11-09-24
Who can refer:
GPs
Who to refer:
- All unilateral pes cavus deformities of unknown cause
- Failure to improve with physiotherapy or podiatry (at least 3 months treatment)
MINIMAL REFERRAL DETAILS:
Length of time since symptoms started
Non-operative management tried.
Who not to refer:
Patients with known neurological conditions and cavus foot shape if asymptomatic.
In the majority of patients with pes cavus the treatment will be non-surgical – with insoles, ankle brace, footwear modifications and physiotherapy being the main treatment options, but in some surgery will be considered.
As the pes cavus deformity will develop in certain neurological conditions it may be the first sign of such as condition developing. As a result, any developing cavus foot should be investigated, particularly if unilateral.
