A physical therapist evaluates a patient with back pain and determines that the patient's pes planus is contributing to this pain. Which orthotic intervention is MOST appropriate for the patient?

A physical therapist evaluates a patient with back pain and determines that the patient's pes planus is contributing to this pain. Which orthotic intervention is MOST appropriate for the patient?

• A. Metatarsal pad
• B. Solid ankle-foot orthosis
• C. Hinged ankle-foot orthosis
• D. Longitudinal arch support

Answer: (D)

When flat feet contribute to back pain, the goal is to address the abnormal foot mechanics that travel up the kinetic chain. Excessive pronation from a collapsed medial arch increases tibial internal rotation and alters knee, hip, and pelvic alignment, which can strain the lumbar spine. A longitudinal arch support reinforces the medial longitudinal arch along the entire foot, helping to reduce pronation during stance and gait. This improves foot posture and decreases the downstream compensations that can aggravate the back. Metatarsal pads focus on the forefoot and don’t correct arch collapse, while solid or hinged ankle‑foot orthoses restrict ankle motion and are used for different, more severe conditions. So the arch support best targets the underlying mechanism linking pes planus to back pain.

When flat feet contribute to back pain, the goal is to address the abnormal foot mechanics that travel up the kinetic chain. Excessive pronation from a collapsed medial arch increases tibial internal rotation and alters knee, hip, and pelvic alignment, which can strain the lumbar spine. A longitudinal arch support reinforces the medial longitudinal arch along the entire foot, helping to reduce pronation during stance and gait. This improves foot posture and decreases the downstream compensations that can aggravate the back.

Metatarsal pads focus on the forefoot and don’t correct arch collapse, while solid or hinged ankle‑foot orthoses restrict ankle motion and are used for different, more severe conditions. So the arch support best targets the underlying mechanism linking pes planus to back pain.