Office-based management of adult-acquired flatfoot deformity

Med Clin North Am. 2014 Mar;98(2):291-9. doi: 10.1016/j.mcna.2013.10.006. Epub 2013 Dec 18.


Adult-acquired flatfoot deformity is associated with dysfunction of the posterior tibial tendon, leading to loss of the medial arch. Patients tend to present with medial pain and swelling, but later in the disease process can also present with lateral-sided pain. The mainstay of nonoperative treatment is nonsteroidal anti-inflammatory drugs, weight loss, and orthotic insoles or brace use. The goals of therapy are to provide relief of symptoms and prevent progression of the deformity. If nonoperative management fails, a variety of surgical procedures are available; however, these require a lengthy recovery, and therefore patients should be advised accordingly.

Keywords: Flatfoot; Hindfoot valgus; Medial ankle pain; Midfoot abduction; Nonoperative management; Posterior tibial tendon dysfunction.

Publication types

  • Review

MeSH terms

  • Adult
  • Ankle / physiopathology*
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use*
  • Combined Modality Therapy / methods
  • Disease Management
  • Disease Progression
  • Flatfoot* / complications
  • Flatfoot* / diagnosis
  • Flatfoot* / physiopathology
  • Flatfoot* / therapy
  • Foot / physiopathology*
  • Foot Orthoses
  • Humans
  • Musculoskeletal Pain / etiology
  • Musculoskeletal Pain / therapy
  • Orthopedic Procedures / methods*
  • Tendons / physiopathology*
  • Treatment Outcome
  • Weight Reduction Programs*


  • Anti-Inflammatory Agents, Non-Steroidal