Treatment
Surgical treatment is only initiated if there is severe pain, as the available operations can be difficult. Otherwise, high arches may be handled with care and proper treatment.
Suggested conservative management of patients with painful pes cavus typically involve strategies to reduce and redistribute plantar pressure loading with the use of foot orthoses and specialised cushioned footwear. Other non-surgical rehabilitation approaches include stretching and strengthening of tight and weak muscles, debridement of plantar callosities, osseous mobilization, massage, chiropractic manipulation of the foot and ankle and strategies to improve balance. There are also numerous surgical approaches described in the literature aimed at correcting the deformity and rebalancing the foot. Surgical procedures fall into three main groups: (1) soft-tissue procedures (e.g. plantar fascia release, Achilles tendon lengthening, tendon transfer); (2) osteotomy (e.g. metatarsal, midfoot or calcaneal); (3) bone-stabilising procedures (e.g. triple arthrodesis).
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