Pes cavus is a condition where the arch of the foot is significantly higher than normal and remains elevated even when bearing weight. This is the opposite of a flat foot. It can occur in one or both feet and ranges in severity. The condition disrupts the foot's natural shock absorption and weight distribution, placing excessive pressure on the ball and heel of the foot.

Genetic factors: High arches can be an inherited trait with no associated health problems.
Neurological disorders: Conditions that cause muscle imbalances are a common cause. These include Charcot-Marie-Tooth disease, cerebral palsy, spina bifida, muscular dystrophy, spinal tumors, and stroke.
Injury or trauma: Fractures, nerve damage, or other traumatic injuries to the foot or ankle can lead to high arches.

Pain in the feet, particularly in the heel and ball of the foot.
Instability and frequent ankle sprains, due to the heel tilting inward (known as heel varus).
Claw toes or hammer toes, where the toes are bent or curled.
Calluses and corns on the heel, ball, or outer side of the foot.
Difficulty finding shoes that fit comfortably.

Physical examination: The doctor will examine your feet, how you stand, and how you walk to assess the shape and flexibility of your arch. They may perform the Coleman block test to check if the hindfoot varus is flexible or rigid.
Medical history: The doctor will ask about your family history and overall health to help determine if there is an underlying cause, particularly a neurological one.
Imaging tests: X-rays or magnetic resonance imaging (MRI) may be used to evaluate the bones, joints, and soft tissues.
Neurological testing: If a neurological disorder is suspected, tests like an EMG (electromyography) or nerve conduction study may be ordered.

Orthotics: Custom-made or over-the-counter shoe inserts can provide arch support, absorb shock, and help distribute pressure more evenly.
Proper footwear: Supportive shoes with good cushioning, a wide toe box, and firm heel support can help reduce pain and improve stability.
Physical therapy: A therapist can help with stretching and strengthening exercises to improve flexibility and correct muscle imbalances in the foot and leg.

No. Mild high arches that do not cause pain or instability may not require any treatment. However, if the condition is progressive (often linked to a neurological disorder), treatment is important to prevent increasing deformity. It is important to see a healthcare provider for a thorough evaluation to determine the cause and best course of action.

Progressive neurological conditions: If the high arches are caused by a progressive condition like Charcot-Marie-Tooth disease, the deformity will likely worsen over time, and ongoing treatment may be necessary.
Non-progressive or idiopathic cases: High arches that are inherited or result from a stable injury are less likely to worsen without treatment. Early intervention can effectively manage pain and prevent complications.

Weight distribution: When standing or walking, people with high arches put most of their weight on the heel and the ball of the foot, especially along the outer edge. This creates excessive stress and poor shock absorption.
Joint instability: Because the foot is less able to adapt to uneven surfaces, high arches can lead to instability and increase the risk of recurrent ankle sprains.
Progressive deformity: Over time, the unbalanced pressure and strain can lead to additional problems, including knee, hip, and back pain.

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