What Are the Different Treatments for Flat Feet Pain?

The arch of the foot is an important structure of the human foot. With the arch, make the foot elastic. It can absorb the impact force of the ground on the feet, and lock the midfoot joints, making the feet hard and better promoting human activities. Flatfoot, also known as flat foot, refers to a deformity in which the arch of the foot is flat or disappears, and the arch of the foot collapses when standing and walking, causing foot pain. Many flat feet, especially children, have no symptoms and do not require treatment. Only a small number of children may gradually cause changes in the physical shape of the whole body, and some flat feet may be associated with abnormalities in the bone structure of the foot, such as vertical talus, Bone union and so on. Among adult flat feet, women are more than 50 years old. When an adult flat foot first starts, the foot arch exists in a non-weight bearing state, and the foot arch disappears after weight bearing. At this time, due to the mobility of the joints, it is called restorable flat foot or flexible flat foot. If joint disease occurs, movement is limited, and deformity cannot be reduced, it is called stiff flat foot.

Basic Information

nickname: Flat feet
English name: flatfoot

Visiting department: surgical
Disease characteristics: Pain in the feet, prominent scaphoid deformity, increased pain after standing or tired

Causes of flat feet

Flat feet can be congenital or acquired. Children's arches often form between the ages of 4 and 6, and most children and adolescents have congenital flat feet. Adult flat feet can be a continuation of children's flat feet, or they can be caused by secondary causes, resulting in arch collapse. Secondary flat feet in symptomatic adults are called adult acquired flat feet. There are many causes of secondary arch collapse such as joint degeneration, trauma, diabetes, rheumatoid arthritis, neuropathy, tumors, and posterior tibial tendon insufficiency.

Clinical manifestations of flat feet

The arch collapse can cause the following structural changes of the foot: Achilles tendon contracture: After the medial longitudinal arch collapses, the moment of the Achilles tendon acting on the ankle joint decreases, and the pulling force of the Achilles tendon cannot be effectively transmitted to the hard arch. Forefoot, in order to push the body forward and lift the heel, the Achilles tendon needs to become shorter, tighter and more powerful; The midfoot is loose. As a result, the middle metatarsal joint cannot be locked; Forefoot displacement: After the medial longitudinal arch collapses, the metatarsal plantar flexion, the calcaneus is dislocated backward, and the anterior tuberosity of the calcaneus no longer supports the talar head. To accommodate this position, both the forefoot and the midfoot are displaced laterally and laterally around the talus. Forefoot abduction, the lateral column of the foot is shortened; The stress of the posterior tibialis tendon increases, and it is prone to strain on the posterior tibialis tendon. In severe cases, there may be damage to the medial ligament of the foot; The subtalar joint is pronated, and the calcaneus is valgus; The instability of the midfoot keeps the subtalar and talar joints in abnormal positions for a long time. Become a fixed deformity. This will put more stress on the ankle joint and eventually cause the ankle joint to degenerate. The above pathological changes can be manifested clinically as:

Pain

It is usually located on the medial side of the foot (pain on the back of the hind foot), and exacerbates after standing or walking for a long time, and it can often be progressively aggravated. Occasional pain can also be located near the lateral lateral malleolus. This is due to the arch of the foot causing the hindfoot eversion, and the fibula and the calcaneus collide.

2. Swelling

Painful swelling outside the joint, even in the scaphoid tubercle.

3. Gait abnormal

Suffering from foot pain and arch collapse can cause running or even walking ability decline, abnormal gait, such as outer eight figure gait.

4. Pain and abnormal gait

Can affect other joints of the body, such as compensatory valgus of the knee joint and compensatory external rotation of the hip due to excessive valgus and internal rotation of the foot, which may cause knee, hip, lower back Pain and arthritis. Individual patients with flat feet may experience back pain as the only symptom.

5. Severe flatfoot deformity

It can be seen that other joints of the foot and ankle are affected, such as the subtalar joint and the transverse sacroiliac joint are reduced in flexibility and even stiffness.

6. Flat feet

May be accompanied by iliac fasciitis and sacral sinus syndrome.

Flat foot examination

During the initial examination, the patient was asked to take a standing position and inspect the force line relationship of the hind and front feet from the front and rear of the ankle. Note the shape of the longitudinal arch of the foot under load. The foot structure may appear normal in the sitting position, but it changes noticeably after the load is applied. This is common in patients with excessively relaxed flatfoot deformities, soft toe deformities, and excessive metatarsophalangeal joint relaxation. From the rear examination, it can be seen that the affected hindfoot is generally valgus, and the "multi-toe disease" due to forefoot abduction. Observe the patient's knee extension unilateral or bilateral lift test from the rear. Failure to perform unilateral iliac crests or lack of symmetrical inversion of the hindfoot indicates the presence of posterior tibial tendon disease.

The auxiliary examination method is mainly X-ray examination. X-ray film of the front and side of the foot should be taken under load conditions, and the angle change of the arch of the foot is mainly measured on the side of the foot.

Flat foot diagnosis

Have a history of congenital abnormalities in foot bones or foot trauma, overload, and weakness of foot muscle ligaments. The longitudinal arch of the foot collapses and the sole of the foot is flat. Heel eversion, standing or prone to fatigue, pain and tenderness. Footprints were used to examine the area without arcuate defects, and determine the type and degree of flat feet. The X-ray film showed that the longitudinal arch of the foot collapsed and the relationship of the metatarsal axis changed.

Flatfoot Treatment

The early detection of flatfoot is very important. After the detection, active inspection and treatment should be carried out to clarify the cause and prevent possible irreversible lesions of bones and joints, not only in adults, but also in children and adolescents with flatfoot. Foot pads are a more commonly used non-surgical treatment, which can relieve pain, support the arch of the foot, and improve the position of dislocated joints. In addition, shoes with hard soles can achieve strong support for the soles of the feet, and shoes with rocker soles can reduce the stress on the ankles during walking. For those with lesions in the ankle, walking boots can be worn to reduce symptoms, but orthoses such as foot pads cannot completely correct the abnormal position of the talus and completely restore the normal arch of the foot. For patients with severe deformity, if non-surgical treatment fails, the corresponding surgery can be selected according to the type of lesion. A series of soft tissue and bone reconstruction procedures can be performed to reconstruct the arch position. In recent years, more subtalar joint stabilization techniques have been performed to effectively reset and stabilize the talus by placing a subtalar joint brake in the sacral canal. The suitable age for placement of subtalar joint stabilizers for children with flat feet is 6-12 years. Because of the subsequent reconstruction of the body, children can rebuild the arch of the foot, and even if the stabilizer is removed, the arch can still be maintained for life. The operation is simple, the trauma is small, the complications are small, and the curative effect is relatively satisfactory. However, for adult patients with flat foot with fixed foot deformity or joint disease, the subtalar joint stabilizer needs to be used in conjunction with other bone or soft tissue surgery to achieve the desired effect.

Flatfoot prevention

Perform functional exercises of the internal and external muscles of the foot, such as foot plantar walking, plantar flexion exercise, and lifted external rotation exercise. At the same time, choosing shoes with good arch support and avoiding standing for long periods of time are of certain significance for the prevention of flat feet.

Understanding the knowledge behind the entry