High arch foot (pes cavus)

A high-arched foot, called pes cavus, has an arch that stays high when you stand. That puts more of your body weight through the heel and the ball of the foot. Many people with high arches have no problems, but others get pain, calluses or ankle sprains. Sometimes a high arch is the first sign of a nerve condition, so it's worth having it checked if it's causing trouble.

What is pes cavus?

Pes cavus is a foot with a high arch on the inside.¹ It's the opposite of a flat foot. It affects about 10% of adults.¹,² It can be present from birth or develop later, at any age, and can affect one or both feet.

Feet with high arches tend to be stiffer than average. Because less of the foot touches the ground, pressure is concentrated in smaller areas, and custom orthoses work partly by spreading that pressure out.³

What causes it?

In many people, a high arch is simply the foot shape they've inherited, and no other cause is found.¹ But in adults with a painful high-arched foot, about two in three have an underlying nerve or muscle condition.¹

The most common of these is Charcot-Marie-Tooth disease (CMT), an inherited condition that affects the nerves to the feet and hands.¹,² A high arch can be one of its first signs.² Other causes include cerebral palsy, spina bifida and polio.¹

A nerve condition is more likely if both feet have high arches, there's a family history of high arches or walking problems, or there is weakness or numbness in the feet or legs.²

Signs and symptoms

High-arched feet can lead to:

• pain under the ball of the foot (metatarsalgia) or the heel¹
• clawed or hammered toes¹,²
• calluses under the ball of the foot or the heel¹
• repeated ankle sprains or an ankle that "gives way"¹
• pain from the tendons on the outside of the ankle (the peroneal tendons)¹
• stress fractures and plantar fasciitis (heel pain)¹
• trouble finding shoes that fit well.⁴

Some people with a nerve-related high arch also find their foot slaps down or catches when they walk, called foot drop.²,⁴

What can help?

Treatment depends on whether the foot is flexible or stiff, and whether there's an underlying nerve condition.

Footwear. Changing your shoes is one of the first things to try.¹ Look for good cushioning, a stable heel and enough depth for any clawed toes.

Orthoses (shoe inserts). Custom orthoses work well for a painful high-arched foot. They ease pain by spreading pressure more evenly across the sole.³,⁵ Ready-made insoles don't seem to have the same effect.³

• If the foot is still flexible, orthoses can be shaped to help the foot sit and move more evenly.
• If the foot is stiff, cushioned orthoses that mould to the foot help spread the load and protect the ball of the foot.

Braces. If a nerve condition has weakened the muscles around the ankle, a brace that supports the foot and ankle (an ankle-foot orthosis) can help you stay mobile.⁴

Other care. Your podiatrist can treat calluses and painful toes, and suggest exercises and changes to your activity.¹

Surgery. If pain continues despite these measures, or the foot is getting worse, an orthopaedic surgeon may suggest an operation to realign the foot.¹

When to see a podiatrist

See a podiatrist if your high arches are painful, you keep spraining your ankle, or you're getting calluses or clawed toes. Get checked sooner if both feet are affected and there's a family history of high arches, or if you notice weakness, numbness, tripping or your foot slapping when you walk.² These can be signs of a nerve condition that needs a doctor's assessment. Take extra care if you have diabetes, because high-pressure areas on the feet can break down.

If high arches are causing you trouble, book an appointment with our podiatrists in Booragoon.

References

1. Qin B, Wu S, Zhang H (2022). Evaluation and management of cavus foot in adults: a narrative review. Journal of Clinical Medicine, 11(13), 3679. https://doi.org/10.3390/jcm11133679
2. Piazza S, Ricci G, Caldarazzo Ienco E, et al. (2010). Pes cavus and hereditary neuropathies: when a relationship should be suspected. Journal of Orthopaedics and Traumatology, 11(4), 195–201. https://doi.org/10.1007/s10195-010-0114-y
3. Burns J, Landorf KB, Ryan MM, Crosbie J, Ouvrier RA (2007). Interventions for the prevention and treatment of pes cavus. Cochrane Database of Systematic Reviews, 2007(4), CD006154. https://doi.org/10.1002/14651858.CD006154.pub2
4. healthdirect Australia (2024). Charcot-Marie-Tooth disease. https://www.healthdirect.gov.au/charcot-marie-tooth-disease
5. Hawke F, Burns J, Radford JA, du Toit V (2008). Custom-made foot orthoses for the treatment of foot pain. Cochrane Database of Systematic Reviews, 2008(3), CD006801. https://doi.org/10.1002/14651858.CD006801.pub2

Reviewed by Andrew Schox, Podiatrist, BSc(Hons) PGradDipPod MPod. Last reviewed October 2026.