Flat Feet (Symptomatic)

Diagnosis/Definition

• Chronic repetitive aching type discomfort in the medial aspect of the foot while standing and walking.
• Decreased medial longitudinal arch height with medial talar head prominence.
• Asymptomatic flat feet do not require treatment.

Initial Diagnosis and Management

• History and physical examination.
• Appropriate radiographic (weightbearing feet) and laboratory studies (rheumatology panel evaluation in patients with inflammatory, bilateral, and other joint presentations).

Ongoing Management and Objectives

• Initial primary care treatment for foot pain should include a three-month trial period of the following: NSAIDs, over-the-counter arch pads for insoles (i.e., Polysorb or Dr. Scholl's), soft supporting shoes (running or walking type), calf stretching and decreased activity (rest). 

Indications for Specialty Care Referral

• Adult patients with no improvement of symptoms after the three-month trial period can be referred to the Podiatry Clinic. 
• Pediatric patients with no improvement can be referred to Podiatry Clinic.
• All Retiree's, VA and dependents with foot conditions 30, 31, 01, 02, 03, 04 etc.. Respectfully need to be routed to Schofield Barracks Podiatry or net worked out for treatment. Tripler Podiatry unfortunately does not provide orthotics or inserts for dependents, VA or Retiree's.

Criteria for Return to Primary Care

• Patients not requiring surgery will be given a biomechanical examination and an orthotic prescription prior to being returned to primary care for chronic management. 
• Patients requiring surgery will be followed in the Podiatry Clinic until the perioperative period is complete. Patients will then be given an orthotic prescription before being returned to the primary care provider for chronic management.