Tuesday, June 8, 1999 Published at 11:59 GMT 12:59 UK
Children's feet at risk
Healthy adult feet depend on good care in childhood
Many Spanish children receive treatment to correct foot problems they do not have - putting them at increased risk of damage, according to a study.
The mistakes increase the costs of child care and could cause unnecessary harm, the researchers said.
It also found that those with genuine conditions were not getting the corrective treatments they needed.
Researchers at Malaga University performed the study, which was published in the online edition of the US journal Pediatrics.
The researchers set out to establish the incidence of flat feet among children aged four to 13, and to see how often children received treatments they did not need.
They looked at 1,181 school children in the Malaga Province and found that 168 had been prescribed orthopedic boots and arch supports.
But on closer examination it turned out that only 30 of the 1,181 had flat feet - of those 30, almost three-quarters were receiving no treatment.
The researchers applied their findings to the whole child population of the province - 200,000 - and estimated that more than 28,000 were getting orthopaedic treatment.
They said this cost 676 million pesetas a year - or £2.6m.
Danger of damage
Antonio Garcia-Rodriguez, one of the study's authors, warned that unnecessary orthopaedic footwear could result in both embarrassment, and damage to the children's feet.
"The results revealed an embarrassing situation that spoke more of opportunism than professionalism," he said.
"Because most of these children had normal feet, the cost of the special footwear represented a considerable unnecessary expense for parents and health services.
"Moreover, many of the children would have suffered psychologically by having to wear ugly boots that become increasingly unacceptable as the child grows older.
"A more serious consideration is the fact that orthopaedic corrective footwear confines the foot in a rigid mould that limits the normal function of the muscles of the foot.
"Unnecessary orthopaedic arch supports cause twofold damage - they initiate and then perpetuate the problem for which they were prescribed ostensibly to correct."
'Unaware of risk'
However, Tim Ponton, chief orthotist at the Nuffield Orthopaedic centre in Oxford, said he was not aware of any such damage.
He is responsible for fitting orthopaedic footwear on the prescription od a consultant, and said similar problems of overuse were unlikely in the UK.
"The debate over when to prescribe orthopaedic shoes has been going on for 35 years," he said.
Children who had flat feet that did not affect their health might be given corrective treatment when they did not need it if their parents were worried, he said.
"The only case where a child is given unnecessary treatment might be when a parent is overconcerned - they see the flat feet and insist on something being done.
"But to the best of my knowledge this cannot do any harm."