Harriet Crisler

Causes Of Foot Pain In The Elderly

Fallen Arches?

Overview

Flat Foot

Also sometimes called "fallen arches", the condition of flat feet is characterized by a lack of appropriate arch in the inner foot. It can be a genetic condition or the result of improper body mechanics. Often the whole of the foot will contact the ground with little to no arch being present. Because a normal foot is structurally able to support the weight of the body thanks to the bone structure that comprises the arch, a flat foot often is unable to properly support this weight and will cause extreme pressure in the joints in the foot and above, such as the ankles, knees and hips. Other problems such as tendonitis, bunion and hammertoe deformities, arthritis of the foot joints, and chronic fatigue of the leg muscles can also result.

Causes

Just as there are many different causes of flat feet, there are also many different treatment options. The most important aspect of treatment is determining the exact type or underlying cause of flat feet that you have. Foot and ankle specialists can determine this through thorough clinical examination and special imaging studies (e.g., x-rays, computed tomography, and/or magnetic resonance imaging). Conservative treatment is effective in the vast majority of flat foot cases, and consists of things such as insoles, splints, manipulation, or casting. Surgery is required much less frequently, and is reserved only for some of the severe types of flat foot that do not respond to conservative therapy. You may have noticed that one common element in the conservative treatment of all types of flat feet is orthoses. Many companies now manufacture semi-custom orthotic devices that not only improve comfort, but also seek to control abnormal motion of the foot. These over-the-counter inserts, in the $25 to $50 range, are an economical treatment that may help a majority of people. Unfortunately, these semi-custom devices will not fit everyone perfectly, and those of us who differ too much from the average may respond better to custom orthotic devices. Custom inserts are prescribed by your foot and ankle specialist and are made individually from either a physical or computerized impression of your feet. The only drawback of custom orthoses is their cost, ranging anywhere from $300 to $500. Many physicians recommend trying over-the-counter inserts first (and even keep them in stock) as they may save their patients large sums of money.

Symptoms

Fallen arches symptoms may include the following. Being unable to slip fingers underneath arches. Inwards rolling of foot and ankle when running. Knee problems due to lack of support from feet.

Diagnosis

Many medical professionals can diagnose a flat foot by examining the patient standing or just looking at them. On going up onto tip toe the deformity will correct when this is a flexible flat foot in a child with lax joints. Such correction is not seen in the adult with a rigid flat foot. An easy and traditional home diagnosis is the "wet footprint" test, performed by wetting the feet in water and then standing on a smooth, level surface such as smooth concrete or thin cardboard or heavy paper. Usually, the more the sole of the foot that makes contact (leaves a footprint), the flatter the foot. In more extreme cases, known as a kinked flatfoot, the entire inner edge of the footprint may actually bulge outward, where in a normal to high arch this part of the sole of the foot does not make contact with the ground at all.

What does it mean when you have flat feet?

Non Surgical Treatment

Treatment of flat feet by a fully educated, trained, and licensed podiatrist should be sought if the previously mentioned pain in the foot or knee areas start to surface and becomes a painful problem. Depending on the cause and exact type of the condition, a variety of forms of treatment may be prescribed. Verification of the exact cause and type of flat feet that each individual has, should only be handled by a professional podiatrist. Often times, the actual treatment method will include some form of arch support or light gymnastic style exercise. In rare cases, something more involved may be necessary, but only your skilled podiatrist would be able to accurately make that determination. If you suffer from flat feet, plantar fasciitis, or any other form of problematic foot condition, we encourage you to contact a foot clinic today and potentially rid yourself of that problem in virtually no time at all.

Surgical Treatment

Flat Feet

Common indications for surgery are cerebral palsy with an equinovalgus foot, to prevent progression and breakdown of the midfoot. Rigid and painful Pes Planus. To prevent progression, eg with a Charcot joint. Tibialis posterior dysfunction, where non-surgical treatment is unsuccessful. Possible surgical procedures include Achilles tendon lengthening. Calcaneal osteotomy, to re-align the hindfoot. Reconstruction of the tibialis posterior tendon. For severe midfoot collapse of the arch, triple arthrodesis may be indicated.
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