The feet are a flexibly structured combination of bones, joints, muscles, and soft tissues that enables us stand upright and perform activities such as walking, running, and jumping.
Arch pain is a common foot condition – it affects runners and other athletes, although it can also occur in people who are less active. The arch of the foot stretches from the base of your toes to your heel and plays an important role in any activity where you are on your feet. The arch of the foot helps:
- Bear body weight
- Create balance
- Stabilize movement
- Adapt changes in terrain
- Absorb shock
Arch pain may be felt in the ball and heel of the foot. You may also feel pain in the top of your foot, or even in your ankles, knees, hips, legs, and back. Depending on the underlying cause, the pain may be worse when walking or standing, or during / after activities involving your feet. It may also be much more intense in the morning when you wake.
Causes & Symptoms
The arches are the primary structures of the body that absorb and return force to and from the body to the outside world when we are on our feet. When something happens to these structures, pain and injury may result. There can be many causes of arch pain. Direct force trauma, ligament sprains, muscle strains, poor biomechanical alignment, stress fractures, overuse, inflammatory arthritis, or the tightness of the joints in the foot may all cause pain in the arch.
Injury to the plantar fascia is a common cause of arch pain. The plantar fascia is the thick, connective tissue that supports the arch on the bottom of the foot. It runs from the calcaneus (heel) forwards to the heads of the metatarsals. When the plantar fascia is damaged, the resulting inflammatory response may become a source of arch pain.
Sprains, strains, bruises, and fractures may be the result of a single stress or a combination of stresses to the foot. Many of the muscles of the lower leg and foot attach on or near to the arch. Injured or tight muscles may lead to incorrect biomechanics and in turn cause arch pain.
Injury to the bones of the foot can be caused by a single blow or twist to the arch or also by repetitive trauma, which can result in a stress fracture. Additionally, a sprain of the arch occurs when the ligaments which hold the bones together are overstretched and the fibers tear. The muscles of the foot may be strained by overstretching, overuse, overloading, bruising, or being cut by stepping on a sharp object. Arthritis of the arch joints may also occur if the foot is subjected to repetitive movements that stress the arch.
As for symptoms regarding foot arch pain, pain and tenderness associated with plantar fascia strains are normally felt on the bottom of the foot and may manifest either as a specific or general area of tenderness. Plantar fascia pain may be increased or decreased by stretching of the arch. Generally, in mild cases of plantar fasciitis, the pain will decrease as the soft tissues of the foot warm-up; however, pain may increase as the use of the foot increases.
The groups of muscles that support the arch of the foot can be divided into two groups. The muscles on the top of the arch begin on the front lower leg and help to lift the arch, and the muscles that help pull the arch on the bottom of the foot are located on the back of the lower leg. Muscle injury may be indicated when pain is felt while the foot is fully extended, flexed, or turned in or out. Pain may also be felt when working the foot against resistance.
Who Gets Foot Arch Pain?
Typically, anyone can experience pain in the arch of the foot – risk factors linked to foot arch pain include:
- Excessive foot pronation – Normally, when the foot lands on the ground it rolls slightly inwards or pronates. An individual who pronates too much, however, puts extra pressure on the inner foot, which can strain the plantar fascia. Excessive foot pronation is common in people who have flat feet.
- High arches – The plantar fascia helps to maintain the foot’s arch; maintaining a high arch may put a strain on the plantar fascia.
- Running – Jogging just a few miles forces the plantar fascia to stretch and contract several thousand times. If the fascia is inflamed or experiencing micro-tears with each step, then running will cause pain.
How Does It Affect You? How Serious Is It?
Any injury or alteration in the structure of your foot can lead to arch pain. Some complications include the following:
This an inflammation of the plantar fascia that causes a stinging pain in the arch or heel of your foot that is usually worse when you first wake up in the morning or after sitting for a long period of time. Your plantar fascia is a thick band of tissue that runs from the back of your heel to the ball of your foot. Too much stress on the tissue, often caused by running, leads to inflammation and swelling of the tissue that causes arch pain.
The bones that are in the midfoot and the metatarsal bones can all be damaged by overuse. When this happens, a stress fracture is a possible injury targeted to the bone. Stress fractures typically occur not as the result of a single injury, but rather repetitive overuse that eventually leads to a crack forming in the bone. Stress fractures usually cause pain that worsens with increased activity. Unlike plantar fasciitis that can loosen with some activity, the pain associated with a stress fracture typically worsens as activity levels increase. Afterward, when a stress fracture occurs, the bone will likely need some rest. In some cases, a walking boot can lead to effective relief, whereas in other situations all weight must be relieved from the bone requiring crutches.
Inflammation of the tendons that pass along the foot can also cause pain in the arch as well. The two most commonly injured tendons that cause arch pain are the tibialis posterior and the peroneal tendons. These tendons start in the leg, behind the ankle, and then to the underside of the foot. Both tendons are important at controlling movements of the foot and ankle.
If the arch of your foot touches against the floor when you’re standing up, then it is possible you have ‘flat feet’. This condition can occur in childhood if your arch isn’t fully developed. However, it is possible for your arches to fall as an adult due to injury, overuse, or excess body weight. Flat feet don’t always cause pain, but you may experience aching in the heel or ball of your feet, especially after activity.
Recommended Treatment & Rehabilitation
Before proceeding for further treatment to help reduce symptoms linked to foot arch pain, your doctor will first perform a physical examination. He / she will begin by evaluating your gait (the way you walk) because the physical problems that cause pain effect the way you walk, and gait problems can cause arch pain. For example, you may overpronate your foot, which is placing the outside part of your foot to the ground before the inside part of your foot. Overpronation is both a cause and a result of arch pain. In addition, another important part of your diagnosis is an examination of the appearance of your foot and leg. Your doctor will feel for any tender or swollen areas where it has been affected. You will have an exam of your neurological function, including your muscle size and strength, reflexes, and sensation. Your arches will also be carefully examined.
After physical examination, your doctor will use the equipment for use in imaging tests to help rule out various conditions. An X-ray is a fast and simple test that provides a good picture of musculoskeletal structures. If your X-ray does not fully explain your symptoms, you might need to have computerized tomography (CT scans) or a magnetic resonance imaging (MRI) test.
When you are diagnosed, a physiotherapist will then work with you to develop a program to help decrease your symptoms. Some of these treatments include:
- Assessment of your gait – on how you walk and how this may impact your symptoms.
- Stretching exercises – to improve the flexibility of your ankle and the plantar fascia.
- Strengthening exercises – to help improve the strength of supporting muscles.
- Taping of the foot – for short-term relief.
- Orthotics and supportive footwear – to minimize abnormal foot motion, or to help support your arch, reducing stress to the plantar fascia.
- Night splints – to help maintain correct ankle and toe positions while sleeping.
- Gait training – to help lessen symptoms and improve your walking ability.
A healthcare provider may recommend a few exercises to help you heal during your process of foot arch pain. Here are some exercise examples you can try at home, such as the following:
Sit on a hard surface with your injured leg stretched out in front of you. Loop a towel around your toes and the ball of your foot and pull the towel towards your body, keeping your leg straight. Finally, hold this position for 15-30 seconds and then relax before repeating 3 times a day.
Standing calf stretch
Stand facing a wall with your hands on the wall at about eye level. Keep the other leg forward with the knee bent, then turn your back foot slightly inwards. Slowly lean into the wall until you feel a stretch in the back of your calf. Hold the stretch for 15-30 seconds, then return to the starting position before repeating 3 times a day.
Seated plantar fascia stretch
Sit in a chair and cross the injured foot over the knee of your other leg. Next, place your fingers over the base of your toes and pull them back towards your shin until you feel a comfortable stretch in the arch of your foot. Hold this position for 15 seconds and repeat 3 times a day.
Plantar fascia massage
Sit in a chair and cross the injured foot over the knee of the opposite leg. Then, place your fingers over the base of the toes of your injured foot and pull your toes towards your shin until you feel a stretch in the arch of your foot. With your other hand, massage the bottom of your foot, moving the heel toward your toes. Do this for 3-5 minutes gently, whilst pressing hard on the bottom of your foot as you become able to tolerate more pressure.
Alternative & Homeopathic Treatment
Homeopathic treatments of arch pain generally consist of relieving pressure from the irritated area on the bottom of the foot, and efforts to control swelling and inflammation. Here are some at-home treatments you can try, such as:
- Rest – Resting the affected extremity is critical in order to reduce inflammation within the arch of the foot. This may require changes in activities or even the use of crutches.
- Ice application – Applying ice to the affected area can be a helpful way to manage inflammation and also reduce pain. Many people find ice massage an effective method to apply cold treatment to this area.
- Anti-inflammatory medications – Non-steroidal anti-inflammatory drugs (NSAIDs) are effective medications to relieve discomfort associated with inflammation.
- Footwear changes – Changes in footwear with more arch support, better cushioning, or other changes can often be helpful. Wearing supportive footwear is essential when managing arch pain.