High arches (pes cavus)

Pes cavus, or high arches, is a foot condition where the arch of the foot is abnormally raised, which can affect balance, cause pain, and lead to specific patterns of wear or discomfort on the sole of the foot. It can be present from childhood or develop later in life. In some cases, it can be a sign of an underlying neurological or neuromuscular condition, particularly if it develops or progresses in adulthood.

Causes include an inherited structural foot shape without any other underlying condition, or, particularly if the condition is progressive or occurs alongside other symptoms, an underlying neurological or neuromuscular condition such as Charcot-Marie-Tooth disease. In many people, high arches are simply a variant of normal foot shape without any underlying disease. Identifying whether there is an underlying cause is an important part of assessment, particularly for progressive or newly developing high arches in adulthood.

Symptoms can include foot pain, particularly under the ball of the foot or heel, instability or a tendency to ankle sprains, difficulty finding comfortable, well-fitting footwear, and sometimes hammertoes or other associated toe deformities. Some people with mild high arches have no symptoms at all. Symptoms tend to relate to how the abnormal arch shape affects weight distribution and foot mechanics during standing and walking.

High arches themselves are not dangerous, but they can contribute to foot pain, instability, and an increased risk of ankle sprains if not appropriately managed with supportive footwear or orthotics. If high arches develop or worsen in adulthood, or occur alongside other neurological symptoms such as weakness or altered sensation, further investigation is important to check for an underlying neuromuscular condition. Once any underlying cause is identified or excluded, most symptoms related to high arches can be well managed with appropriate footwear and supportive measures.

Treatment usually involves supportive footwear with good arch support and cushioning, and often custom orthotic insoles to help redistribute pressure more evenly across the foot. Physiotherapy can help address any associated muscle imbalance or instability. In more severe cases with significant deformity or pain not responding to conservative measures, surgical correction may occasionally be considered by a foot and ankle specialist.

Mild to moderate high arches are generally managed rather than fully "corrected," using supportive footwear and orthotics to reduce symptoms and improve comfort and stability, rather than changing the underlying foot shape itself. More significant deformities, particularly if causing substantial pain or functional problems, may be considered for surgical correction by a specialist. The right approach depends on the severity of the high arch and the specific symptoms it is causing.

High arches (pes cavus) involve an abnormally raised foot arch, often associated with instability and pressure concentrated under the ball of the foot and heel, whereas flat feet (pes planus) involve a reduced or absent arch, with the whole sole of the foot tending to make more contact with the ground. Both can cause foot pain and benefit from supportive footwear or orthotics, though the specific type of support needed differs between the two conditions. A podiatrist or foot specialist can assess your specific foot shape and recommend the most appropriate supportive approach.

See a podiatrist or foot specialist if high arches are causing pain, instability, or difficulty with footwear, so appropriate supportive measures can be recommended. A private podiatry or orthopaedic assessment can typically be arranged within about one to two weeks. See a doctor promptly if high arches develop or worsen in adulthood, particularly alongside other symptoms like weakness or numbness, since this pattern warrants investigation for a possible underlying neurological cause.