The high arched or pes cavus foot provides challenges in clinical practice. The first thing that needs to be established is the cause of the pes cavus. Neurological causes need to be ruled out initially as this condition can be first sign of several different problems. The treatment of pes cavus will depend on the cause of any symptoms. The pain in pes cavus can be from pressure on the metatarsal heads, so accommodative type foot orthotics are often needed. If the pain is in the arch or heel, then more supportive foot orthotics are indicated. If the pain is further up the lower limb, functional foot orthotics may be needed to change the function of the foot. If the pain is on top of the foot, then footwear advice is often needed. If all else fails then pes cavus surgery is indicated.

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