Yes, there are lots of options, from simple arch supports to custom-made orthotic devices to foot reconstruction surgery — decidedly a last resort.

Flat feet are normal in children under 3. Those chubby little feet simply haven’t had time to develop fully, so children have fat where adults have arches. Not until adolescence — or earlier, if a child chronically complains of tired or achy feet — is it a good idea to consult a doctor about flat feet.

With adults, flat feet may need medical attention if they cause pain and fatigue or if the feet tip so far inward that you feel strain and pain up through the knee, hip, or back.

Flat feet, also called fallen arches, can lead, in severe cases, to feet “as flat as a pancake,” said Dr. Lloyd Smith, a doctor of podiatric medicine in Newton and the immediate past president of the American Podiatric Medical Association.

In adults with painful flat feet, what sometimes happens is that the tendon that runs down the inside of the ankle to the arch “becomes inflamed, weakened and in some cases, becomes incompetent,” said Dr. Kris Di Nucci, an Omaha ankle surgeon and spokesman for the American College of Foot and Ankle Surgeons. Other things can also lead to flat feet, including a fracture or dislocation in the middle of the foot. Some people also get flat feet for hereditary reasons.

To reduce inflammation in the arch tendon, nonsteroidal anti-inflammatory drugs such as ibuprofen can help, said Dr. Michael Lee, a foot and ankle surgeon in Des Moines who headed a team that wrote flat-foot guidelines in March for the foot and ankle surgeons’ group.

If arch supports, orthotic devices (which cost from $200 to $500) and exercises don’t work, you can try surgery, but it may involve moving bones and inserting a plastic screw — not a trivial undertaking.