Causes of Arch Pain and Treatment Options

 Causes of Arch Pain and Treatment Options

There are several reasons why you may experience pain in the arches of your foot. Your foot arches, which are essential for support of your body weight, are formed by bones, ligaments, and tendons.

Weakness or injury of any of these structures can cause arch pain. The shape and height of your foot arches are unique; no two people are the same. And major variations in the shape and height of your arch can make you more susceptible to pain.1

Treatment includes strategies like foot support, medication, therapy, and possibly interventional procedures as well. Paying attention to good foot and arch support is fundamental to preventing arch pain.

Overuse, injury, weakness, inflammation, and anatomical variations in the structure of your arches can all trigger arch pain. And there is a good chance that you could have more than one cause.

The natural arch of your feet can be described as high, neutral or flat. High and flat arches are more likely to cause pain if you experience triggers, such as overuse. Some congenital (from birth) arch deformities can make you more susceptible to pain, even without a trigger.

There are a number of causes of arch pain, including:
High Arches

A high arch is also called pes cavus or cavus foot. A high arch can make you more prone to overuse injuries when you play sports or run.2 High arches do not absorb shock very well and they don't provide much support while walking.
Flat Feet and Fallen Arches

Adults can naturally have flatfoot or can acquire a flatfoot deformity when the posterior tibial tendon in the back of the lower leg becomes weak. The resulting foot shape is often called fallen arches.2

Conditions such as cerebral palsy, muscular dystrophy, Charcot-Marie Tooth disease, and spina bifida are neuromuscular problems that cause musculoskeletal deformities, including changes in the shape of the arch.
Acquired Conditions

Spine disease, neuropathy, muscle atrophy, and polio are examples of conditions that can lead to weakened leg and foot muscles, increasing the likelihood of arch weakness and pain. Being overweight can also place excessive pressure on your foot, causing your arches to hurt.3
Nerve Problems and Foot Pain

An injury to the foot or leg can cause weakness and a change in the position of the foot, leading to arch pain.
Triggers and Exacerbating Factors

When your foot arch is already prone to pain, things like a lack of arch support, overuse, standing for long periods of time, or having your leg or foot in an unusual position can put an extra strain on your arches and may cause inflammation.

You can, however, experience arch pain even if you don't have a condition that makes you susceptible to pain, especially if you are frequently exposed to these exacerbating factors.
When to See a Doctor

If you have mild arch pain, you should rest and consider icing the painful area. If you have recurrent pain, persistent pain, or if you notice swelling, redness, weakness, or decreased sensation, you should see your doctor.

Even if you know the cause of your arch pain, it can worsen if you don't get medical attention. Putting stress on the muscles of your legs can eventually cause even more pain to develop in your arches and in the rest of your foot, legs, or hips. And sometimes, persistent pain can cause you to position your foot awkwardly, resulting in sores, ulcers, and even misshaped toes.

Your diagnosis is based on a history of your symptoms, your physical examination, and possibly imaging tests such as x-rays.
Physical Examination

Your doctor will evaluate your gait (the way you walk) because the physical problems that cause pain the arch of your foot can also affect 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 (the inside and outside should hit the ground at the same time). Overpronation is both a cause and a result of arch pain.

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. You will have an exam of your neurological function, including your muscle size and strength, reflexes, and sensation. Your arches will be carefully examined.

Your foot has three distinct arches:

Medial Longitudinal Arch: The medial longitudinal arch is the most prominent foot arch and what is typically referred to as simply, "the arch." It runs from front to back along the inside of your foot. This arch absorbs the majority of the shock of impact while walking, jumping or running.
Lateral Longitudinal Arch: The lateral longitudinal arch runs parallel to the medial longitudinal arch along the outer edge of the foot. It is most visible in people with very high arches.
Transverse Arch: The transverse arch runs across the midfoot from outside to inside. This arch also provides support and flexibility to the foot.

Imaging Tests

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 a computerized tomography (CT) or a magnetic resonance imaging (MRI) test.
Differential Diagnosis

Arch pain is associated with several changes in the arches of the foot. Plantar fasciitis, which is inflammation of any of the structures of the arch, is the most common diagnosis. It is typically diagnosed based on your clinical examination, and your diagnostic tests are likely to be normal.
What Is Plantar Fasciitis and What Can I Do About It?

Your doctor may detect weakness of muscles or tendons in your leg, such as the posterior tibial tendon. Bone malformations and traumatic injuries can often be seen on imaging examinations.

There are several treatment options for arch pain. The right treatment for you depends on the cause. Conservative treatments include customized arch support devices or foot and ankle braces.

If you have high arches, you may benefit from cushioned shoes and custom-molded shoe inserts to help with shock absorption. If you have a low arch (flat foot), custom shoe orthotics and stretching the Achilles tendon is often recommended. The treatment may progress to a walking boot, physical therapy, or even surgery.

A typical at-home exercise involves rolling a ball or a pop can under your foot for a few minutes each day.

Be sure to get advice and a diagnosis from your doctor or therapist before doing at-home exercises, so that you won't exacerbate your problem.

Physical therapy may focus on strengthening your Achilles tendon in your ankle and the tibialis muscle in the back of your leg, which can help alleviate undue pressure on your arches.

Medication, including injections of anti-inflammatory and/or pain medications, can help as well. And when there is a reparable anatomical defect, surgery may be necessary.
What to Expect When Having Plantar Fascia Surgery

You might not necessarily think about protecting your arches if you have not experienced pain. But if you are an athlete, or if you are on your feet all day, you can prevent problems with arch pain by selecting your footwear properly. Wearing supportive shoes designed for fitness is important, even if you participate in sports as a hobby. Sometimes, inserts can be placed inside shoes to provide the right arch support.4

Maintaining good form goes a long way too. If you are a runner or a tennis player, for example, it is important that you learn how to position yourself the right way so that you will decrease your chances of developing pain.
A Word From Verywell

Arch pain is very common. But that doesn't mean that you should ignore it. Sometimes, at-home exercises, simple arch support, or a more supportive shoe can alleviate the problem. Pay attention to proper stretching and posture when participating in recreational sports to prevent injuries and inflammation. It is a good idea to talk with a coach so you can learn the safest techniques.

If your symptoms persist, personalized therapy, customized devices, medications, or surgery are necessary to avoid complications.

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