Cavus Foot

Structural and Postural Conditions· Also known as: high-arched foot, high arches, pes cavusUpdated Oct 2026

Reviewed by Andrew Schox, BSc(Hons) PGradDipPod MPod, October 2026

At a Glance

Cavus foot is a high arch that doesn't flatten when you stand. Estimates of how common it is run from about 10 per cent of people up to one quarter, because there is no single agreed definition. Many people have no symptoms at all. For others it causes foot pain, calluses, clawed toes or a wobbly ankle that sprains easily. A high arch can sometimes be linked to a nerve or muscle condition, so it is worth having it checked. Custom-made shoe inserts can ease pain in adults, though they may not stop the foot from changing over time.

What is it?

Cavus foot (also called pes cavus) is a foot with a high arch. Unlike a normal arch, it stays high when you put your weight on it. The high point can be at the front of the foot, the middle, the heel or a mix of these.

Cavus foot covers a wide range. At one end is a harmless foot shape with no symptoms. At the other end is a stiff, painful foot that is out of balance. Some high-arched feet are flexible and can still adjust when you stand. Others become stiff and fixed.

Who does it affect?

Estimates of how common it is run from about 10 per cent of people to one quarter. No firm figure exists, because people define a high arch in different ways.

You are more likely to have a cause that needs checking if both of your feet are affected, or if high arches, foot deformity or walking problems run in your family. A high arch in one foot only is more often linked to an earlier injury, or sometimes to a problem in the nerves of the brain or spine.

Signs and symptoms

Many people have a high arch and never have a problem. When it does cause trouble, you may notice:

pain, most often under the ball of the foot on the big toe side
hard skin (calluses) and sore pressure areas on the ball and outside of the foot
toes that curl up or claw
a heel that tilts inwards
an ankle that feels unstable or gives way

A high arch can also make you roll your ankle often. Over time, this can overload the outside of the foot and ankle.

What causes it?

Often the cause is a muscle imbalance in the foot and leg. Some muscles pull harder than others, and the arch is pulled up. This imbalance is often due to a nerve or muscle condition. The most common one is Charcot-Marie-Tooth disease, an inherited condition that affects the nerves in the feet and legs. A foot change is often one of its first signs.

Other causes include an old foot or ankle injury, clubfoot present from birth, and some other conditions that affect the nerves or spine. In some people no cause is found. A high arch can also just be the way your foot is shaped.

Because a nerve or muscle condition is so often behind a high arch that turns the heel inwards, your podiatrist will want to rule it out. This does not mean you have one.

How is it diagnosed?

Your podiatrist will ask about your pain, any ankle sprains and your family history. They will look at your feet while you stand and watch you walk. They will also check your ankle movement and look for calluses, clawed toes and pressure areas.

A common check is the Coleman block test. You stand with the outside of your foot and heel on a small block, with the big toe side hanging off the edge. This shows whether your heel can straighten up (a flexible foot) or whether it is fixed. The result helps guide the type of shoe insert you need.

Your podiatrist will also do a basic nerve check, including strength, feeling and reflexes. If anything suggests a nerve condition, you may be sent for more tests. X-rays taken while you stand can show how severe the arch is. If only one foot is affected and no other cause is found, scans of the brain and spine are needed to rule out treatable problems.

Treatment

If your high arch doesn't bother you, you may not need any treatment. When it is painful, care usually starts with shoe inserts, shoes and activity changes. Treatment can ease symptoms but may not stop the foot from changing, especially when a nerve condition is the cause.

Looking after it at home

Cutting back on the activities that bring on your pain can help. Shoes that make room for your foot and cushion it (accommodative footwear) are part of usual care. Anti-inflammatory medicines are also often used for painful flare-ups.

Stretching and strengthening exercises, often guided by a physiotherapist or podiatrist, can ease symptoms, improve how your foot works and reduce the strain on it.

Treatment from your podiatrist

Custom-made orthoses (shoe inserts made for your feet) are the best-supported treatment for a painful high arch in adults. Over three months they eased foot pain and improved how the foot worked more than dummy inserts did. They also spread out the pressure under the foot: pressure fell by 26 per cent with custom-made orthoses, compared with 9 per cent with dummy inserts. People whose pressure was spread out more tended to get more pain relief.

The design depends on your foot. If your heel can straighten on the block test, the high arch is driven by the front of the foot. A recess under the big toe joint and a bar behind the ball of the foot can help. If the problem is mainly in the heel, the insert is usually firmer and runs the full length of the foot. It has a raised heel and a wedge along the outside, and no support under the inner arch.

Milder cases may be managed with orthoses alone. Your podiatrist will usually review your pain and how well you are moving after about three months.

Other options

If your foot is stiff or fixed, shoe inserts may be less comfortable and less helpful. Your podiatrist may suggest a brace that goes up around the ankle and foot (an ankle-foot orthosis, such as the Arizona brace).

Custom-made inserts are the only treatment with trial support for easing foot pain in people with a high arch. Whether off-the-shelf inserts work as well as custom-made ones isn't yet clear.

Surgery

If these treatments aren't enough, your podiatrist may refer you to a foot and ankle specialist, such as an orthopaedic or podiatric surgeon. Before surgery is discussed, a nerve or spine cause should be ruled out. Missing one can lead to the wrong operation, the problem coming back and a poor result.

If the foot can still correct, surgery on the soft tissues alone may be enough. For children and teenagers whose deformity keeps getting worse, some specialists favour earlier surgery, because waiting can make the foot stiffer.

After surgery, follow your surgical team's written advice. This includes keeping your leg raised and changing position regularly, because pressure sores can form under a cast. Numbness or tingling for a while is common. Some people are left with patches of numbness, and a painful, over-sensitive nerve reaction (Complex Regional Pain Syndrome) is rare. Wound infection is uncommon and usually clears with a short course of antibiotics. Contact your surgical team if you are worried or notice signs of infection.

Recovery

The outlook depends mainly on the cause. If your high arch is just the way your foot is shaped, you may have few or no problems. If a nerve condition such as Charcot-Marie-Tooth disease is behind it, the foot usually starts flexible in childhood or the teenage years and slowly becomes fixed. How fast this happens is hard to predict.

Orthoses, footwear changes, activity changes and exercise can ease pain and help you move better. They may not stop the foot changing over time, especially when a nerve condition is the cause.

A heel that tilts inwards puts extra load on the outside of the foot and ankle. Over the years this can lead to repeated ankle sprains, a long-term wobbly ankle, and problems with the tendons on the outside of the ankle. It can also cause stress fractures (small cracks) in the outer foot bone, ankle arthritis, plantar fasciitis (heel and arch pain) and clawed toes. This is why repeated sprains or pain on the outside of your foot are worth getting checked early. Regular reviews are helpful, especially for children and teenagers and when a nerve cause is known or suspected.

Preventing it

You can't prevent the high arch itself, especially if it runs in your family. What you can do is look after your feet and catch problems early. Keep up with your exercises, wear your inserts and shoes as advised, and see your podiatrist for reviews.

If you are active, build up your training gradually. If you wear minimalist shoes (thin, flexible shoes with little cushioning), give your feet time to adapt. Get ongoing pain at the front or outside of your foot checked.

It isn't yet clear whether any particular insert, shoe or exercise prevents ankle sprains or stress fractures in people with a high arch.

When to see a podiatrist

Book an appointment if

You have a high arch and it hurts, or it causes calluses, clawed toes or sore pressure areas. You keep rolling your ankle, your ankle feels unstable, or you have ongoing pain on the outside of your foot. You also have a family history of high arches, foot deformity or walking problems, or you are unsure whether your high arch needs checking.

Seek prompt assessment if

Your foot suddenly changes shape, or a high arch appears suddenly in one foot along with new weakness, numbness, balance problems or bladder or bowel changes: see your GP or another doctor today. If your GP can't see you today, go to an urgent care clinic or an after-hours GP. You have a high arch in one foot only, your arch is changing quickly or looks different between your feet, or you notice worsening weakness or numbness in your feet or legs: see your GP soon, because these can be signs of a nerve or spine problem. You have joint swelling that doesn't settle and has no clear cause: see your GP soon.

Frequently asked questions

Is cavus foot hereditary?

It can be. The most common cause is Charcot-Marie-Tooth disease, an inherited nerve condition, so high arches can run in families. Tell your podiatrist if relatives have high arches, foot deformity or walking problems. A high arch with no cause found, or a harmless foot shape, can also occur.

Will shoe inserts from the chemist help?

The inserts that eased pain in adults with painful high arches were custom-made for the person's feet. Whether off-the-shelf inserts work as well isn't yet clear. If your arch is painful, ask your podiatrist which type suits your foot.

What is the difference between pes cavus and cavovarus?

Pes cavus describes the high arch when the foot is viewed from the side. Cavovarus describes a foot where the heel and front of the foot also turn inwards, so the shape changes in three dimensions. The two terms are often swapped, but they point to different causes and care, so ask your podiatrist which applies to you.