Pes cavus

Alternative names 
High arch; High foot arch

Definition
High arch, or pes cavus, is when the toe-to-heel arch of the foot is excessively elevated.

Causes, incidence, and risk factors

High arch is the opposite of flat feet. Highly arched feet are much less common than flat feet and more likely to be associated with an abnormal orthopedic or neurological condition. Neuromuscular diseases that cause changes in muscle tone may be associated with the development of high arches.

Unlike flat feet, highly arched feet tend to be painful because more stress is placed on the section of the foot between the ankle and the toes (metatarsals). Highly arched feet may make it difficult to fit shoes, generally require a foot support, and can cause significant disability.

Symptoms

     
  • the foot length may be shortened because much of it is taken up in the arch  
  • difficulty fitting shoes  
  • foot pain associated with walking, standing and running

Signs and tests

     
  • X-ray of the feet  
  • X-ray of the spine  
  • MRI of the spine  
  • electromyography  
  • nerve conduction studies

Treatment

Corrective shoes may help to relieve pain and can improve walking. This includes orthopedic modifications to the shoes, such as an arch insert and a support insole. Surgery to flatten the foot is sometimes necessary in severe cases.

Expectations (prognosis)
The expectations depend on the underlying neurological condition, although in mild cases, appropriate shoewear and arch supports may provide excellent relief.

Complications

     
  • chronic pain  
  • difficulty walking

Calling your health care provider
Call your health care provider if you suspect you are having foot pain related to high arches.

Prevention
People with highly arched feet should be evaluated for underlying neurological and orthopedic conditions. Identifying these other conditions may help prevent or lessen impending arch problems.

Johns Hopkins patient information

Last revised: December 7, 2012
by Mamikon Bozoyan, M.D.

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