High Arch: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats High Arch?
An orthopedic foot and ankle specialist, a bone and joint doctor who focuses on the foot, often treats a high arch. A neurologist, a nerve doctor, may help when a nerve problem is the cause. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is a high arch?
A high arch is a foot arch that is raised more than normal. The arch runs from the toes to the heel on the bottom of the foot. Doctors also call it pes cavus. It is the opposite of flat feet, and high arches are much less common than flat feet. Pes cavus is seen in both children and adults.
Symptoms
Symptoms of a high arch can include:
- Shortened foot length.
- Trouble fitting shoes.
- Foot pain with walking, standing, and running. Not everyone has this symptom.
- Frequent ankle sprains, arch pain, and sometimes knee pain.
- Painful calluses, which are thick, hard patches of skin.
Hammertoes, which are toes that bend abnormally, are also common. Complications may include long-term pain. They may also include trouble walking.
Causes and who gets it
A high arch can be caused by a bone or nerve condition. Pes cavus is often a sign of an underlying nerve problem. The most common cause is a group of inherited nerve diseases, most often Charcot-Marie-Tooth disease. Other nerve-related causes include cerebral palsy, stroke, spinal cord lesions, and polio.
When both feet are affected, the cause is often inherited or present from birth. A high arch in only one foot is more often linked to an injury. Untreated or undertreated clubfoot can also lead to a high arch.
How doctors diagnose it
A doctor looks at your foot while you stand. The instep, the middle of the foot, looks hollow. Your provider will check whether the high arch is flexible, meaning it can be moved around. Doctors may also check how well your nerves, reflexes, and sensation work.
Tests that may be done include:
- X-rays of the feet or spine.
- Electromyography and nerve conduction studies, which check how well nerves and muscles work.
- An MRI of the spine.
- Genetic testing.
A high arch in only one foot with no clear cause should lead to an MRI of the brain and spinal cord.
Treatment
High arches, particularly ones that are flexible or well cared for, may not need any treatment. Orthotics, which are inserts placed in shoes, may help the symptoms. Corrective shoes may help relieve pain and improve walking. Standard nonoperative options also include activity changes, anti-inflammatory medicines, and custom orthoses. Stretching and strengthening are reasonable first options.
Surgery to flatten the foot is sometimes needed in severe cases. Surgery can include moving tendons, cutting and realigning bones, and fusing joints. When a nerve disease such as Charcot-Marie-Tooth is the cause, the foot often keeps getting worse without surgery. Any nerve problems must be treated and monitored by specialists.
When to see a doctor
Contact your provider if you think you have foot pain related to high arches. Also tell your doctor about increasing pain, repeated ankle sprains, a foot shape that is getting worse, skin breakdown, or trouble walking or fitting shoes. A high arch that starts suddenly in one foot, along with nerve symptoms, may point to a sudden problem and should lead to more testing.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Such a doctor can check your feet, order first tests, and refer you to a foot and ankle specialist or a neurologist. Primary care doctors play a role in spotting a high arch as a possible sign of a wider health problem and starting a referral.
Common questions
Is a high arch the same as pes cavus?
Yes, high arch and pes cavus are two names for the same foot shape.
Does a high arch always need treatment?
No, a high arch does not always need treatment. Flexible high arches or ones that are well cared for may need none.
Can a high arch be a sign of a nerve problem?
Yes, it can be. Doctors may check for nerve and bone conditions in people with high arches.
Why can a high arch be painful?
A high arch can be painful because more stress is placed on the part of the foot between the ankle and toes. Not everyone with a high arch has foot pain.
Sources
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
