Direct attention away from asymptomatic flat feet in healthy children

This review concluded that there is no evidence to support the efficacy of FOs for children with asymptomatic (painless) flat feet.

Further, the evidence across 4 decades remains very limited, with ill‐defined conclusions about FOs for treating paediatric flat feet.

Very‐low to low‐certainty evidence from 2 studies evaluating the effectiveness of FOs for foot and ankle pain in children with juvenile idiopathic arthritis (JIA) found inconclusive evidence on the benefits of FOs on pain, child and parent‐rated quality of life, quality of life, or withdrawals due to adverse events.

While less frequent, children with painful flat feet are directed to use low‐cost prefabricated FOs with well‐selected footwear. Footwear, a given influence for FOs, is demonstrated to alter gait and foot mobility, and hence requires regard in both clinical and research settings. Available normative foot posture data, triage principles, and wider diagnoses must be considered before any intervention occurs.

Given the lack of difference between the low-cost prefabricated FOs and the expensive customised FOs, and the benefits of early treatment, clinicians may consider immediate use of prefabricated FOs for JIA foot and ankle pain. JIA is indisputably consequential, and many children experience disabling foot and lower-limb pathology despite best available pharmaceutical measures.