Drexel University College of Medicine

Diseases and Conditions

High arch

Definition

High arch is an arch that is raised more than normal. The arch, or instep, runs from the toes to the heel on the bottom of the foot. It is also called pes cavus.

High arch is the opposite of flat feet.

Alternative Names

Pes cavus; High foot arch; High instep

Causes, incidence, and risk factors

High foot arches are much less common than flat feet. They are more likely to be caused by a bone (orthopedic) or nerve (neurological) condition.

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 toes (metatarsals). This condition can make it difficult to fit into shoes. People who have high arches usually need foot support. A high arch may cause disability.

Symptoms

• Shortened foot length
• Difficulty fitting shoes
• Foot pain with walking, standing, and running (not everyone has this symptom)

Signs and tests

When the person stands on the foot, the instep looks hollow and most of the weight is on the back and balls of the foot (metatarsals head).

Your health care provider will check to see if the high arch is flexible, meaning it can be moved around.

Tests that may be done include:

• Electromyography
• MRI of the spine
• Nerve conduction studies
• X-ray of the feet
• X-ray of the spine

Treatment

High arches -- especially ones that are flexible or well cared for -- may not need any treatment.

Corrective shoes may help relieve pain and improve walking. This includes changes to the shoes, such as an arch insert and a support insole.

Surgery to flatten the foot is sometimes needed in severe cases. Any nerve problems that exist must be treated by specialists.

Expectations (prognosis)

The outlook depends on the condition causing high arches. In mild cases, wearing appropriate shoes and arch supports may provide 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 checked for nerve and bone conditions. Identifying these other conditions may help prevent or reduce arch problems.

References

Physician Reference

International Classification of Diseases, 9^th Revision (ICD9)

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