Flexible flat feet that are painless do not require treatment. If pain due to flexible flat feet occurs, an orthotic (arch supporting insert in the shoe) can bring relief. With the increased interest in running, many shoe stores carry shoes for normal feet and pronated feet. The shoes designed for pronated feet make long distance running easier and less tiring as they correct for the positional abnormality.
Rigid or painful flat feet require the evaluation of a health care provider. The exact treatment depends on the cause of the flat feet. For tarsal coalition, treatment starts with rest and possibly casting.
If this fails to improve the pain, surgery may be necessary to either resect the fused bone or actually completely fuse several bones in a corrected position. For problems with the posterior tibial tendon, treatment may start with rest, anti-inflammatory medications, and shoe inserts or ankle braces.
In more advanced cases, surgery may be necessary to clean the tendon, repair the tendon, or actually fuse some of the joints of the foot in a corrected postion in very advanced cases.
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