What Causes Pain In The Arch

Overview
Pes planus is the scientific term that describes low arch or "flat" feet. As podiatric physicians, we are very interested not only in structure but also in function of the feet. While very few people have 20-20 vision, it is also true that very few people have perfect arch structure. High and low arch feet are just the two ends of the spectrum of foot structure. The more deviation from what is considered perfect, the worse the function becomes. We describe deviation from "the ideal" as imbalance in structure. It is the imbalance in structure that leads to abnormal function. Abnormal function causes pain and/or deformity. Deformity can manifest itself in a variety of foot problems such as bunions or hammertoes. Likewise, pain can manifest itself in a variety of ways such as heel pain ( plantar fasciitis or heel spur), corns or calluses, metatarsalgia or pain in the ball of the foot ( neuromas, stress fractures, or tendonitis), or even in pediatric problems. Invariably, we can treat most foot imbalance or biomechanical insufficiencies with orthotic therapy.


Causes
There are several reasons why arch pain develops. Sometimes it?s due to a condition known as plantar fasciitis, in which the plantar fascia (the band of tissue that runs along the bottom of your foot from your heel to your toes) becomes inflamed after excessive stress. Heel pain results from this inflammation. Sometimes the pain is due to extensive time spent on your feet. Many people feel pain on the arch of their feet after a long workday, while others overuse their feet exercising or playing sports. A foot deformity, such as hammertoe or clubfoot, can also cause this pain. Medical conditions such as diabetes or obesity can put additional stress on your feet, thereby causing arch pain. Your footwear is also important. Shoes should support all parts of your foot, especially the bottom. This is very important if you spend excessive time on your feet, if your obese, if your pregnant, or if you engage in sport-related activities. Injuries to any of the twenty-six bones, thirty-three joints and over 100 muscles, tendons and ligaments in the feet can also cause arch pain. Because the foot is such a complex structure, it?s important to see a podiatrist at the first sign of symptoms.

Symptoms
Symptoms of arch pain and arch strain are found in the underside of the foot, where the foot arch is. Arch pain and arch strain is actually inflammation of the tissue in the midfoot, formed by a band that stretches from the toes to the heel. The arch of the foot is needed for the proper transfer of weight from the heel to toe. When the band forming the arch of the foot or plantar fascia becomes inflamed, it becomes painful to perform simple tasks.

Diagnosis
Your doctor may order imaging tests to help make sure your heel pain is caused by plantar fasciitis and not another problem. X-rays provide clear images of bones. They are useful in ruling out other causes of heel pain, such as fractures or arthritis. Heel spurs can be seen on an x-ray. Other imaging tests, such as magnetic resonance imaging (MRI) and ultrasound, are not routinely used to diagnose plantar fasciitis. They are rarely ordered. An MRI scan may be used if the heel pain is not relieved by initial treatment methods.

Non Surgical Treatment
Treatment for flat feet and fallen arches depends on the severity and cause of the problem. If flat feet cause no pain or other difficulties, then treatment is probably not needed. In other cases, your doctor may suggest one or more of these treatments. Rest and ice to relieve pain and reduce swelling. Stretching exercises. Pain relief medications, such as nonsteroidal anti-inflammatories. Physical therapy. Orthotic devices, shoe modifications, braces, or casts. Injected medications to reduce inflammation, such as corticosteroids.


Surgical Treatment
Surgery for flat feet is separated into three kinds: soft tissue procedures, bone cuts, and bone fusions. Depending on the severity of the flat foot, a person?s age, and whether or not the foot is stiff determines just how the foot can be fixed. In most cases a combination of procedures are performed. With flexible flat feet, surgery is geared at maintaining the motion of the foot and recreating the arch. Commonly this may involve tendon repairs along the inside of the foot to reinforce the main tendon that lifts the arch. When the bone collapse is significant, bone procedures are included to physically rebuild the arch, and realign the heel. The presence of bunions with flat feet is often contributing to the collapse and in most situations requires correction. With rigid flat feet, surgery is focused on restoring the shape of the foot through procedures that eliminate motion. In this case, motion does not exist pre-operatively, so realigning the foot is of utmost importance. The exception, are rigid flat feet due to tarsal coalition (fused segment of bone) in the back of the foot where freeing the blockage can restore function.


Prevention
Stretch and strengthen important muscles in your feet, ankles and legs in order to guard against future strain. Make sure to acquire suitable arch supports and inserts if necessary, and that your shoes are shock absorbent and in good condition. Wearing tattered shoes provides no protection, and runners should replace their footwear before exceeding 500 miles of usage. Athletes new to arch supports should gradually build their training routine, allowing their feet to become accustomed to a new stance.

Stretching Exercises
Plantar Fasciitis stretches should always be gentle and pain free, if discomfort occurs with or after stretching decrease the intensity and duration of stretches. Stretches can usually be gradually progressed in intensity and duration over time according to individual tolerance. Plantar Fasciitis Stretch 1. Stretch for the right calf muscle (gastrocnemius) and the arch of the right foot (plantar fascia and muscles under the arches). Take your right heel close to the wall and ball of the foot upright against the wall. Move your hips forwards to the wall. Try to keep your right leg straight. Push down through your right heel to increase the stretch. Maintain for 30 seconds, repeat 2-3 times. Plantar Fasciitis Stretch 2. Stretch for the outside belly of the right calf muscle and the arch of the right foot. Take your right heel close to the wall. Turn the ball of your right foot outwards to 2 o?clock position upright against the wall. Move your hips forwards to the wall. Turn your trunk in the opposite direction (i.e. to the left). Try to keep your right leg straight. Push down through your right heel to increase the stretch. Maintain for 30 seconds, repeat 2-3 times. Plantar Fasciitis Stretch 3. Stretch for the inside belly of the right calf muscle and the arch of the right foot. Take your right heel close to the wall. Turn the ball of your right foot inwards to 10 o?clock position upright against the wall. Move your hips forwards to the wall. Turn your trunk in the opposite direction (i.e. to the right). Try to keep your right leg straight. Push down through your right heel to increase the stretch. Maintain for 30 seconds, repeat 2-3 times. Plantar Fasciitis Stretch 4. Stretch for the right achilles tendon and the arch of the right foot. Take your right heel close to the wall and ball of the foot upright against the wall (as for stretch 1). Move your hips forwards to the wall. Bend your right knee forwards into the wall keeping the ball of your foot upright against the wall. Push down through your right heel to increase the stretch. Maintain for 30 seconds, repeat 2-3 times.