Flat Feet

Q: I have flat feet and pain in my left foot from putting too much pressure on it. I bought some inserts for my shoes. They help, but are there more effective ways to stop the pain and inflammation?

A: There may be better ways to treat your flat feet.

We usually don't know what causes this common condition (called pes planus) in adults. The arch collapses. This increases the stress on the joints, tendons and tough connective tissue (called the plantar fascia) along the sole.

Shoe inserts (also called insoles or orthotics) can be quite helpful but there are many types. Some are stiff. Others are soft. Some lift up the arch more than others. Foot doctors (podiatrists) often recommend custom-fit inserts. These mold to the shape of your foot. These may be the most effective, but they are also the most expensive. And they are rarely covered by health insurance.

Other options to treat flat feet include pain relievers, such as acetaminophen, or anti-inflammatory drugs, such as ibuprofen. When a tendon or specific area of the plantar fascia is inflamed, a cortisone injection may be helpful.

However, none of these treatments corrects the problem. Occasionally, surgery is recommended as a last resort.

I would recommend seeing a podiatrist to review all of your treatment options.

Robert Shmerling, M.D., is associate physician and clinical chief of rheumatology at Beth Israel Deaconess Medical Center and an associate professor in medicine at Harvard Medical School. He is an active teacher in the Internal Medicine Residency Program, serving as the Robinson Firm Chief. He is also a teacher in the Rheumatology Fellowship Program and has been a practicing rheumatologist for over 25 years.