Arch Pain Overview
Each foot has two arches – the longitudinal arch which runs the length of the foot, and the transverse arch which runs the width. The 26 bones, ligaments & muscles of the foot, along with a tough, sinewy tissue known as the plantar fascia, provide secondary support to the foot. There are also fat pads in the foot to help with weight-bearing and absorbing impact. Arch pain can occur whenever something goes wrong with the function or interaction of any of these structures.
Arch Pain Causes
Direct force trauma, ligament sprains, muscle strains, poor biomechanical alignment, stress fractures, overuse, inflammatory arthritis, the tightness (or lack of) in the joints of the foot may all cause arch pain.
Injury to the plantar fascia is a common cause of arch pain. The plantar fascia is the thick, connective tissue which supports the arch on the bottom of the foot. It runs from the 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.
Stress fractures, plantar fasciitis, and acute and chronic arthritis are most commonly the result of repetitive micro-trauma injuries. Factors that commonly contribute to this type of injury can be running on uneven surfaces or surfaces that are too hard or too soft, wearing unsupportive shoes that have poor shock absorption qualities, or overdoing repeated bouts of exercise.
Arch Pain Symptoms
Pain and tenderness associated with plantar fascia strains are usually felt on the bottom of the foot, or at the heel area. Generally, in mild cases of plantar fasciitis, the pain will decrease as the soft tissues of the foot “warm up”, but in more severe cases, pain may increase as use of the foot increases, or when the arch is stressed.
Point tenderness and looseness of a joint are indicators of a ligament sprain/fracture. Muscle injury may be present if pain is felt when the foot is fully extended, flexed, or turned in or out. Pain may also be felt when working the foot against resistance.
The tissues that compose the arch do not provide much protection. Things like stepping on a rock & other blows to the foot can result in pain, discolouration, swelling etc. These symptoms & any changes in how you walk may indicate more serious damage.
Proper evaluation and diagnosis of arch pain is essential in planning treatment. Four grades can be used to describe arch pain:
- Pain during activity only
- Pain before and after activity,but not affecting performance
- Pain before, during, and after athletic activity which does affect performance, and
- Pain so severe that performance is impossible.
When to Seek Medical Care
When the pain begins to interfere with activities of daily living or if you cannot perform your desired activities without pain, you should consider seeking medical attention. Other indicators that you should seek medical care are if the area looks deformed, becomes exquisitely tender to the touch, or is causing you to move differently.
Arch Pain Treatment
When you first begin to notice discomfort or pain in the area, you can treat yourself with rest, ice, compression, and elevation (RICE). Over-the-counter medications may also be used to reduce discomfort and pain, as advised by your Doctor/Pharmacist.
Once the severity and cause of arch and foot pain is determined, a course of corrective and rehabilitative actions can be started.
- Therapists may use machines and/or manual therapies to reduce pain and increase circulation to the area to promote healing.
- Modification of activity – e.g. substituting high impact activities like running, with cycling & swimming etc may be advised..
- Purchase new shoes – Athletic shoes lose the elastic properties of the soles through usage and age. A good rule of thumb is to replace your shoes every six months, more often if there is heavier usage.
- Custom Orthotics or Over the Counter Arch Supports may also improve the biomechanics of the foot & help ease the arch pain.
- Focus on muscle strengthening and flexibility. You may be given exercises to increase the strength and stability of the affected area and to correct muscles that may not be balanced.
- Follow up with your Doctor/Physiotherapist until you are better. They should advise on a plan for a gradual return to normal activities, once the pain is reduced and muscle strength and flexibility are restored.