Each foot contains 24 bones, which form two arches. The longitudinal arch runs the length of the foot, and the transverse arch runs the width. The bones of the arch are primarily held together by the shape with which they fit with each other and by fibrous tissues known as ligaments that serve to hold the bones to each other. The 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 Symptoms:
Arch pain and tenderness associated with plantar fascia strains are usually 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 use of the foot increases. In more severe cases of plantar fasciitis, pain may increase when the arch is stressed.
A more specific pain (point tenderness) is an indicator that something is wrong in that specific area. Pain with movement of the affected area is also an indicator of the particular body part affected.
Bones and ligaments work together to form joints, and bones are joined together by ligaments. Strains occur in ligaments. In the arch, there are ligaments that are located at the ends of each bone. These ligaments connect the bones to other bones on both ends and on the sides. Point tenderness and looseness of a joint are indicators of a sprain.
Fractures are indicated by point tenderness that may be severe over the area of bone that is affected. There may be a distinguishable lump or gap at the site of the fracture. A rotated toe or forefoot may also be a sign of a fracture.
The groups of muscles that support the arch can be divided into two groups. The muscles on the top of the arch start 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 the on back of the lower leg. Muscle injury may be indicated when 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.
Bruises are the result of a direct-force injury to the body. A bruise can occur to the foot by a variety of causes, such as having your foot stepped on or by stepping on a rock. The tissues that compose the arch do not provide that area of the body much protection. Blows to the foot that result in pain, discoloration, swelling, and changes in how you walk may indicate more serious damage.
Arch pain may have a variety of different causes. Proper evaluation and diagnosis of arch pain is essential in planning treatment. A good general guideline is to compare the injured side to the uninjured side. Injury may present itself as a distinguishable lump, a gap felt at that location, or a "crunchy" feeling on that spot caused by inflammation. The type, causes, and severity of pain are also good indicators of the severity of the injury.
Arch Pain Causes:
The most common cause of arch pain is Plantar Fasciitis which is a condition that refers to the inflammation of the tissues connected to the heel bone. This is due to excessive pulling and stretching of the fibrous bands that support the arch of the foot.
Other causes of arch pain can be:
- Tarsal Tunnel Syndrome - A pinched nerve at the ankle that refers pain to the arch.
- Foot strain from a pronated foot or flat foot.
- Osteoarthritis of the joints in the midfoot that can cause arch pain.
Prevention & Treatment:
If the arch pain is related to over pronation (flat feet) then an orthotic (corrective insole) or simple arch support may be the best solution. Off the shelf foot orthotics should have good arch support and good heel stabilisation.
Wear supportive shoes, preferably made of leather, with a low heel and removable insoles. By combining an orthotic with sensible shoes the arch pain should be eradicated.
- For instant relief use ice packs and anti-inflammatory gels. No longer than 20 minutes.
- Compression and elevation will help prevent any swelling of the affected arch tissues.
- Rest will allow the arch tissues to heal themselves by preventing any further stress to the affected area.
Professional Care:
When the pain becomes unmanagable or if you cannot perform your daily activities without pain, you should consider seeing a Podiatrist or orther healthcare professional. Other indicators that you should seek professional advice are if the area looks deformed, becomes exquisitely tender to the touch, or is causing you to move differently.
