Foot Pain Diagnosis

Flexible Pes Cavus Deformity

Cavus foot is a condition involving an abnormally high arch in the foot. When walking or standing, this condition places more weight than normal on the ball and heel of your foot, causing pain and instability, among other symptoms. Cavus foot equally affects individuals of all ages, from all backgrounds, and can appear in either or both of your feet. High-arched feet are less common than flat feet but are more likely to cause pain and other problems.

Pes cavus may be hereditary or acquired, and the underlying cause may be neurological, orthopedic or neuromuscular. Pes cavus is sometimes, but not always connected through Hereditary Motor and Sensory Neuropathy Type 1 (Charcot-Marie-Tooth disease) and Friedreich's Ataxia; many other cases of pes cavus are natural.Pes Cavus

A high arched foot predisposes an individual to a variety of symptoms because of the manner in which this type of foot absorbs force. The excess loading on the base of the big toe can predispose people to develop sesamoiditis and sesamoid fractures. Traction forces lead to repetitive loading of the tendons on the outside of the foot and therefore predispose patients to develop peroneal tendonitis. Compression forces are increased on the inside of the ankle, which makes damage to the inside (medial) aspect of the ankle joint more common potentially leading to talar osteochondral injuries or even ankle arthritis. The structure and loading patterns of a high arch foot also make it more susceptible to: ankle sprains; fractures on the outside of the fifth metatarsal (Jones fractures); and pain directly under the great toe (sesamoiditis).

Diagnosis of cavus foot includes a review of the patient?s family history. The foot and ankle surgeon examines the foot, looking for a high arch and possible calluses, hammertoes, and claw toes. The foot is tested for muscle strength, and the patient?s walking pattern and coordination are observed. If a neurologic condition appears to be present, the entire limb may be examined. The surgeon may also study the pattern of wear on the patient's shoes. X-rays are sometimes ordered to further assess the condition. In addition, the surgeon may refer the patient to a neurologist for a complete neurologic evaluation.

Non Surgical Treatment
Initially a careful investigation is needed to rule out any neurological condition that is causing the high arched foot. This will depend on what is causing the pain, if anything. For instance, flexible high arches may not need any treatment. Wear shoes with a good cushioning, depth and arch support which may help relieve pain and improve walking. Debridement of corns and calluses. Various pads made from silicone or felt can be used to get pressure off the painful areas. Control body weight to decrease load on the feet. Physical therapy modalities such as laser therapy for associated tendonitis. Foot and ankle joint manipulations to help increase joint range of motion. Foot orthotic devices can provide support for stressed joints and soft tissues.

Surgical Treatment
Most people with cavus feet do not need operations. However, if your cavus feet cause a lot of pain, rub badly on your shoes so that the skin breaks down, or your foot pain during yoga ( or ankle are very unstable, and simple treatment has not helped, it may be worth considering an operation to straighten your foot. Your GP can refer you to an orthopaedic foot and ankle surgeon to advise you about surgery.Supinated Foot
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