Arch Pain

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Man holding his foot and possibly experiencing pain in the arch of the foot

Pain in the arch of the foot is unfortunately one of the more common foot problems experienced today. This is especially the case amongst physically active individuals.  This pain is especially common among athletes in high impact activities that require plenty of running or walking.

We usually refer to the arch as though it were a single unit. However, it actually comprises three separate arches that form a triangle along the bottom of your foot.

Two of these arches run longitudinally along the bottom of your foot, i.e. from front to back. They are known as the medial (inner) and lateral (outer) longitudinal arches. The third runs across the front of your foot and is known as the anterior transverse arch. The apex of the “triangle” is located at the heel of your foot.

Causes Of Foot Arch Pain

In the most general sense, most cases of foot arch pain are due to one or both of two things:

  • An injury to the foot; or
  • A structural deficiency of the foot.

Either of these problems can be aggravated by several factors, of which the most common are:

  • Age, i.e. they tend to become worse as one gets older;
  • Overuse, i.e. they tend to be made worse by plenty of high impact activity such as walking, running or jumping;
  • Being overweight;
  • A variety of neurological problems of which stroke and palsy are two of the more common examples.

Structural Deficiencies

The most common structural problems that can cause foot arch  pain are overpronation, plantar fasciitis and pes cavusPTTD (adult acquired flat foot) and pes planus (flat feet) are other common structural problems that can play a role.

Overpronation

This is one of the more common causes of arch pain. It is the tendency to strike the ground first with the outer part of the heel as you take a step. This is then followed by a tendency to roll the foot inwards to the arch as you complete the step. The pressure from the inward rolling of the foot causes the foot arches to flatten over time.

Over time, this habit can damage the muscles, tendons and ligaments of your foot. It can also lead to chronic pain, not only in the foot arches, but also in your knees, hips or back. You may also start to develop other foot problems such as hammer toe and foot corns or calluses.

Plantar fasciitis

This is an extremely unpleasant condition. It is due to the degeneration of the fibrous tissue that runs along the bottom of your foot.

This tissue runs from your toes to your heel bone and is known as the plantar fascia.

In addition to pain in the arch of your foot, plantar fasciitis is also a common cause of heel pain.

Plantar fasciitis can itself be a result of an injury. The injury can be a traumatic one (due for example to jumping and then landing in an uncontrolled manner). Such an injury can lead to inflammation of the plantar fascia and then to plantar fasciitis.

However, it can also be due to overuse or repetitive stress of the plantar fascia. This may happen after long periods of running or jumping activity, for example.

Pes Cavus

Pes cavus (or cavus foot) is a structural abnormality of the foot that is characterized by unusually high arches.

This abnormality may itself be a result of genetic factors or of neurological disorders. Examples of the latter are a stroke, cerebral palsy or Charcot-Marie-Tooth disease.

If you have pes cavus, the simple acts of walking or standing may cause you to feel pain in your feet.

In addition, your high arches may cause instability when standing. This means that your ankle has to work extra hard to maintain your balance. As a result, you may have a tendency to suffer ankle sprains or other injuries.

As with overpronation, this condition can lead to secondary problems over time. These may include claw toe, hammer toe and corns or calluses.

Posterior Tibial Tendon Dysfunction (PTTD)

PTTD is also known as adult acquired flat foot. It is usually a result of an injury to the tendon connecting one of your calf muscles to your inner foot. This tendon plays a key role in supporting the arches of the foot.

Injury to this tendon can therefore result in collapsed arches. This can in turn lead to pain on the inside of the ankle and back of your calf. The pain usually increases in intensity while you walk briskly or run and stops when you stop this activity.

Pes Planus

This is the reverse of the pes planus condition described above and is characterized by flattened arches. This problem may occur without PTTD or overpronation as described above.

Pes planus can cause foot arch pain, but it can also result in painful feet, legs and ankles. You may even experience back pain as a secondary effect of this problem.

Home Based Treatments For Pain in the Arch Of The Foot

In many cases, you may be able to treat your foot arch pain by simple lifestyle modifications.These may include:

  • Taking a temporary break from high impact activities such as those requiring running or jumping. These activities can stress your arches and a rest will allow them to recover naturally. Another possibility is a temporary switch to lower impact activities such as cycling or swimming;
  • In addition to resting, ice or a cold compress can be helpful in reducing pain. Apply it to your arches for periods of 15-20 minutes and do this every 2-3 hours during the day. Be careful to avoid prolonged direct contact between your bare skin and the ice. Use a towel or insulating cloth to avoid this or you may suffer skin damage.
  • Many individuals with flattened arches find that walking barefoot aggravates their foot and ankle pain. To reduce this pain, consider wearing shoes (or even just socks) at all times, even when indoors.
  • You can buy cheap over the counter foot supports to increase arch support and reduce pain;
  • Use a night splint such as the Body Armor when sleeping. It will provide additional arch support that will help ease your pain;
  • Losing weight will place less stress on your foot arches and help reduce the pain;
  • A daily routine of foot and calf stretches can often help to ease pain in the arch of your foot.

Treatment Of Foot Arch Pain By A Doctor Or Podiatrist

In some cases, your foot arch pain may not respond to the above home based treatments. If so, you may need to consult a doctor or podiatrist.

Before proposing a treatment plan, their examination will include a physical examination of your feet. They will likely want to study your gait (i.e. how you walk). This will  help them identify issues such as pronation or balance/co-ordination problems, for example.

Other parts of the examination may include imaging scans such as X rays, CT Scans, ultrasounds or even an MRI study.

Having completed the examination, they may recommend some or all of the following:

  • Wearing ankle braces in cases of PTTD;
  • Surgery to correct structural arch problems;
  • Cortisone injections;
  • Using prescription pain relief medication to mitigate the pain if it is severe (be careful of side effects, however);
  • A podiatrist can design custom orthotics to improve your arch support. They are generally more effective than over the counter inserts but are also more expensive.

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