Flat Feet (Pes Planus) in Adults: Symptoms, Relief, and Treatment in the UK

Flat feet, medically known as pes planus, is a common condition where the arches on the inside of the feet are low or absent. When standing, the entire sole of the foot touches the floor. While many people are born with flat feet or never develop arches, others develop 'fallen arches' later in life, a condition known as adult-acquired flat foot.

In the UK, it is estimated that a significant portion of the adult population has some degree of pes planus. For many, it causes no functional issues. However, when the structure of the foot changes, it can alter the alignment of the ankles, knees, and hips, potentially leading to chronic musculoskeletal pain. Understanding whether your flat feet require treatment depends largely on the presence of symptoms and their impact on your daily activity.

Not everyone with flat feet will experience discomfort. However, common symptoms that indicate you may need to seek advice include:

• Pain in the arch: A dull ache or sharp pain located on the inside of the foot.
• Swelling: Persistent puffiness along the inner ankle or arch area.
• Leg and back pain: Pain in the calves, knees, hips, or lower back caused by poor foot alignment.
• Overpronation: The foot rolling inward excessively when walking, which may cause your shoes to wear out faster on the inner side.
• Difficulty standing: Feeling that your feet become tired or painful after standing for short periods.

According to NHS guidance, you should monitor if your feet feel stiff or if the arches have recently become flatter, as this could indicate an underlying issue with the posterior tibial tendon.

While some cases are hereditary, several factors can lead to the development of flat feet in adulthood:

• Age-related wear: The tendons that support the arch can stretch and weaken over time.
• Obesity: Carrying excess weight puts increased pressure on the arches of the feet.
• Injuries: Broken bones in the foot or damage to the posterior tibial tendon, which runs along the inside of the ankle.
• Health conditions: Rheumatoid arthritis or diabetes can affect the structural integrity of the foot.
• Pregnancy: Hormonal changes and weight gain can cause the arches to temporarily or permanently flatten.

Identifying the cause is essential for determining the most effective treatment for X UK musculoskeletal concerns.

Treatment for flat feet usually follows a conservative, non-surgical pathway aligned with NICE (National Institute for Health and Care Excellence) clinical standards. Options include:

1. Supportive Footwear

Avoid wearing flat, unsupportive shoes like flip-flops or ballet pumps for long periods. Look for shoes with built-in arch support and a firm heel counter.

2. Orthotic Insoles

Off-the-shelf or custom-made orthotics can help redistribute pressure and correct overpronation. These are placed inside your regular shoes to provide an artificial arch.

3. Physiotherapy and Exercise

Specific exercises can strengthen the muscles that support the arch. Common movements include towel curls (using your toes to scrunch a towel) and calf stretches to relieve tension in the Achilles tendon.

4. Pain Relief

Over-the-counter medications such as paracetamol or ibuprofen can manage inflammation and discomfort. Always consult a pharmacist or doctor before starting new medications.

If you are struggling with foot discomfort, you can speak to a GP online to discuss your symptoms from the comfort of your home. A virtual consultation is a convenient first step to:

• Discuss the duration and severity of your foot pain.
• Get advice on appropriate over-the-counter pain relief tailored to your health history.
• Receive a referral for a private podiatrist or NHS physiotherapy services.
• Obtain a sick note if foot pain is severely limiting your ability to work in a standing role.

An online GP can help differentiate between simple flat feet and more complex issues like tendonitis or plantar fasciitis, ensuring you get the right management plan early.

Beyond clinical treatments, you can manage flat feet symptoms with simple lifestyle adjustments:

• Maintain a healthy weight: Reducing the load on your arches can significantly decrease pain levels.
• Rest and Ice: If your feet are swollen after exercise, use an ice pack for 15 minutes to reduce inflammation.
• Low-impact exercise: Switch high-impact activities like running for swimming or cycling to protect your joints while staying active.
• Foot stretches: Regularly stretching the calves and the soles of the feet can prevent the stiffness often associated with pes planus.