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high arches

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Arch of foot

Alternative Names
pes cavus, supinator

Definition
A foot with a very high or hollowed arch is known as pes cavus. A pes cavus foot can be rigid or flexible. A rigid cavus foot looks the same with weight off or on the foot. A flexible cavus foot has a high arch when there is no weight on the foot. The arch decreases when the person puts weight on the foot.

What is going on in the body?
In a person with high arches, the weight of the body is concentrated on the ball and heel of the foot. A flexible cavus foot often leads to plantar fasciitis, an inflammation of fibrous tissue under the skin of the sole.

What are the signs and symptoms of the condition?
A person with high arches will have:
  • pain in the heel or ball of the foot
  • possible pain in the arch on both the top and bottom of the foot
What are the causes and risks of the condition?
One of the most common causes of high arches is a loss of nerve function to the muscles of the foot. Other causes include:
  • diabetes
  • poliomyelitis, a disorder caused by a virus that affects the whole body including muscles and nerves. It may cause permanent muscle paralysis, disability, and deformity.
  • a spinal tumour, a mass within or surrounding the spinal cord
  • muscular dystrophy, a disorder characterised by progressive muscle weakness and loss of muscle tissue
  • Charcot-Marie-Tooth disease, a progressive wasting of muscles in the arms and feet
  • congenital abnormality, or birth defect
  • muscle contractures following severe burns. A muscle contracture is a condition in which the muscle is tight and prevents normal mobility.
If the high arches are not treated, the joints of the foot can be damaged. Sometimes the foot can become misshapen or deformed.

What can be done to prevent the condition?
There is no way to prevent the problem.

How is the condition diagnosed?
The condition can be diagnosed just by looking at the shape of the foot. An x-ray may be performed to help in the diagnosis. Sometimes high arches are caused by an underlying condition, such as diabetes, which needs to be identified and treated.

What are the long-term effects of the condition?
The most common long-term effect is pain from too much stress on small areas of the foot. If the cause is a nerve disorder, surgery may be needed to repair the foot.

What are the treatments for the condition?
If an underlying disease is the cause, it must be treated. Symptoms can often be relieved with the right shoes. Shoes should:
  • fit properly
  • have good shock absorption
  • have laces, which provide room for the foot
Specialty shoe stores may help because they can provide careful attention to shoe fit. Inlays and pads inside the shoes can support the arch and take pressure off the painful areas. Most over-the-counter inlays don't work very well because they don't provide enough support under the arch. Custom support devices called foot orthotics can be prescribed by a doctor. They are often very helpful because they are precisely moulded to the arch and provide extra support to relieve stress on the foot.

What are the side effects of the treatments?
If high arches are untreated, the person's ability to perform activities of daily living can be affected. It can be difficult for an individual to get enough exercise for cardiovascular health, so chronic health problems can develop.

What happens after treatment for the condition?
Inlays and shoes should be checked often to make sure they are still in good working order. There should be no change in shape. Inlays must continue to support the foot.

How is the condition monitored?
A person with high arches should have periodic visits with a doctor.

Author: Bill O'Halloran, DPM
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Contributors
Potential conflict of interest information for reviewers available on request


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