Arch Pain Overview
The human foot is a complex biomechanical structure that bears not only the static weight of the body, but also forces equal to many times the static weight during walking/running. Each foot has two arches (which run the length and width of the foot), twenty six bones plus numerous ligaments, muscles, tissues and fat pads which all contribute to weight-bearing and absorbing impact. Arch pain can occur when something goes wrong with any of these structures.
Arch Pain Causes
Arch pain has a wide range of potential causes including; direct force trauma, ligament sprains, muscle strains, poor biomechanical alignment, stress fractures, overuse, inflammatory arthritis and tightness or looseness in the foot joints.
Injury to the plantar fascia (a thick, connective tissue which supports the arch on the bottom of the foot and which runs from the heel to the metatarsals), is a common cause of arch pain. When the plantar fascia is damaged, it can results in a painful, inflammatory response known as plantar fasciitis.
Conditions like plantar fasciitis, stress fractures and acute and chronic arthritis are often the result of repetitive ‘micro-trauma’ injuries. Such injuries are commonly the result of; impact on hard or uneven surfaces, wearing unsupportive footwear with poor shock absorption qualities, or excessive exercise.
Arch Pain Symptoms
Pain and tenderness associated with plantar fascia strains are usually experienced on the underside of the foot, or in the heel area. In mild cases of plantar fasciitis, pain may decrease as the soft tissues of the foot “warm up”. However, in more severe cases, pain may increase when pressure is applied to the foot, or when the arch is stressed.
Tenderness and joint looseness may indicate a ligament sprain/fracture. If pain is felt when the foot is fully extended, flexed, turned in or out or has pressure applied to it, this may be a sign of muscle injury.
The tissue that forms the arch does not provide much protection and therefore impact on hard surfaces can lead to pain, discolouration and swelling. These symptoms may, in turn, indicate more serious injury.
Proper evaluation and diagnosis of arch pain is essential for planning effective treatment. Arch pain can be categorised into four grades:
- Pain during activity only
- Pain before and after activity,but not during
- Pain before, during, and after activity which also affects performance
- Pain so severe that performance is impossible.
When to Seek Medical Care
Medical help should be sought when pain (a) interferes with daily life or (b) prevents performance of sporting or leisure activities. Other indicators of the need for medical intervention are if the affected area; looks deformed, becomes excessively tender, or is preventing normal movement.
Arch Pain Treatment
In early stages of discomfort or pain, self-treatment with rest, ice, compression, and elevation (RICE) can be effective. Over-the-counter medications. as advised by a doctor or pharmacist, can also be used.
When the level and cause of arch pain has been accurately assessed, a treatment plan can be started and may include:
- Use of machines and/or manual therapies to minimise pain, increase circulation to and promote healing
- Modification of activity – e.g. replacing high impact activities like running, with cycling and swimming
- Replacing ‘worn out’ footwear – a good rule of thumb is to replace sports shoes at least every six months or more often if there is very heavy use.
- Wearing custom orthotics and arch supports can very effective in easing arch pain.
- Improving muscle strengthening and flexibility to increase stability in the affected area and to correct muscles that may not be balanced.
- Once pain is reduced, doctors/Physiotherapists can advise on a plan for a gradual return to normal activities