Foot arch pain which is not plantar fasciitis

Last updated on May 7th, 2023 at 05:14 pm

Foot arch pain is a common problem that can cause significant discomfort and immobility. Often, pain that is felt in the foot’s arch is considered plantar fasciitis or plantar heel pain. However, the pain can be caused by various factors, including structural problems, muscle tightness and injury.

Treatment options vary depending on the underlying cause of the pain. However, they may include rest, ice, compression, and elevation (RICE), stretching and strengthening exercises, physical therapy, appropriate footwear, orthotics, weight loss or more invasive treatment such as surgery. Read on to learn more about some causes other than plantar fasciitis that can lead to foot arch pain.

What is the foot arch?

The foot arch is a curved structure that spans the bottom of the foot, from the heel to the metatarsal bones. It is made up of bones, ligaments, tendons, and muscles and helps to support the body’s weight. Any of these structures can get injured. The arch is highest in the middle of the foot at the inside (the medial side). It gradually decreases in height towards the outside or lateral edge.

The foot’s arch plays an essential role in shock absorption and balance and helps to redistribute weight across the foot. People with high arches are susceptible to foot injuries, as they have less surface area in contact with the ground, which reduces stability.

Low arches can also lead to problems, as they can cause excessive stress on the joints and muscles of the foot. The ideal foot arch height is generally somewhere in between these two extremes. However, what is normal varies among individuals.

Causes of foot arch pain other than plantar fasciitis

Although plantar fasciitis can cause arch pain, it is most often felt at the medial heel. As such, many different issues can lead to foot arch pain. Common causes include:

Structural problems. Issues with the bones or joints in the feet can result in pain in the arches. This includes conditions like flat feet (pronated) or high arches (Supinated).
Muscle tightness. When the muscles in the feet are tight, it can pull on the bones and tissues in the feet and cause pain. Activities that put repetitive stress on the feet, such as running or dancing, are the leading cause.
Injury. Acute injuries to the feet, such as a sprained ankle, can also lead to arch pain.

Other structures that can be injured

Structures running along the arch can also get injured and cause pain unrelated to plantar fasciitis. These include:

Abductor hallucis. This muscle spans the medial arch and can get damaged or strained, leading to pain. This is rare! Also, it’s possible to get tendonitis of the abductor hallucis tendon. It usually occurs from overuse, weight gain as well as inappropriate footwear.
Flexor hallucis tendon. The flexor hallucis tendon can degenerate due to overuse, causing tendonitis of the tendon, thus causing pain in the arch.
Tibialis posterior tendon. Tendonitis of the posterior tibialis tendon can also occur where it inserts into the navicular bone. Again this happens mainly through overuse and can cause debilitating pain.
Spring ligament. Although injury to this ligament is relatively uncommon, it can happen in people with flat feet or a posterior tibialis injury. The symptoms can mimic arch pain.
Sustentaculum tali. According to Della Rocca et al (2009), injury to the sustentaculum tali is rare and involves a high-energy mechanism. In other words, a great force can sometimes lead to a fracture (1). The pain from this injury is felt in the arch as well.
Baxter’s nerve. Referred pain from Baxter’s nerve can cause pain in the arch. Individuals suffering from Baxter’s neuritis pain can feel a sharp, burning, shooting, numbing, tingling, or pins and needles like sensation. Typically, the nerve does not cause any problem unless irritated by atrophy of the abductor digiti quinti muscle, heel spur, or other injuries. Having your clinician check for these other pathologies may be a good idea. Please note that plantar fasciitis and heel spur pain are two different things but can occur together.
Deltoid ligament. The deltoid ligament, located at and spans the inside ankle, elicits referred pain in the arch area if it is sprained or injured.

Symptoms of foot arch pain

Symptoms include pain on the bottom of the foot and along the medial (inner) side. The most common symptom is tenderness or pain, which may worsen when standing or walking for long periods. In some cases, foot arch pain may also cause an ache or burning sensation in the foot. Depending on the type of injury, the pain may dissipate with activity or get worse. Tendon-related pain may ease with moving or walking, but the pain may worsen for other structures as the day progresses.

Diagnosing foot arch pain

If you are experiencing arch pain which is not plantar fasciitis, it is essential to see a clinician so they can determine the underlying cause of your pain. Your clinician will ask about your medical history and symptoms and will likely perform a physical examination of your feet.

They will palpate and carry out specialist tests where applicable to see if any biomechanical abnormalities are contributing to the condition. They may also observe your gait to see if it’s a factor. Further, they may order X-rays or other imaging tests to rule out other conditions which could be causing your pain. Once they have diagnosed your condition, they will develop a treatment plan to help relieve your symptoms and fix the problem.

Treatment Options for Foot Arch Pain

The treatment plan for foot arch pain will vary depending on what is causing your symptoms. In many cases, simple home care measures are all that’s needed to relieve discomfort. This may include:

Over-the-counter medication: These include ibuprofen or its gel counterpart for pain relief.
RICE: Rest, ice, compression, and elevate for 48 hours after injury.
Epson salt or magnesium sulfate bath: Na et al (2011) believe there is some evidence to suggest that magnesium sulfate may help reduce pain levels. However, the mechanism of action still needs to be correctly understood (2).
Massage: This may help if the injury or pain is not acute but chronic. Massage warms the area causing vasodilation, increases blood flow, removes waste products, breaks down scar tissue, and help aligns disarrayed collagen fibres.
Supportive footwear: Use footwear with a supportive arch and a rocker bottom.

Remember that you may also need to avoid activities that put pressure on your feet until your symptoms improve. If home care measures are not enough to relieve your symptoms, you may need additional treatment from a healthcare professional. Treatment options include:

Physical therapy: A physical therapist or physiotherapist can teach you exercises to stretch and strengthen the muscles around your feet to relieve pain and prevent further injury.
Orthotics: Custom shoe inserts can help correct structural problems with your feet, such as excessive pronation. They help to alleviate discomfort.
Surgery: In some cases where other treatments have failed, surgery may be recommended to release the tension on the tendons in your feet or fuse bones together to stabilize them; however, this is typically only considered as a last resort when all other options have been exhausted.

Can foot arch pain be prevented?

In many cases, yes! Wearing supportive shoes, stretching regularly, doing appropriate levels of physical activity, keeping your weight or BMI at a proper level and avoiding activities that place severe repetitive stress on your feet can all help prevent foot arch pain.

Who is at risk?

Anyone can develop foot arch pain not related to plantar fasciitis. However, individuals which high BMI, recreational athletes, athletes who are involved in jumping sports, people who predominantly maintain a sedentary lifestyle, those with hypermobile joints, those affected by rheumatoid arthritis and young people who are still growing.

Prognosis

If the underlying cause of your pain is not addressed, the prognosis for resolving your symptoms can be poor. In some cases, surgery may be required to correct the underlying problem. However, with appropriate treatment, most people will significantly improve their symptoms.

Questions your clinician may ask about your arch pain

When did you first begin experiencing symptoms?
Do your symptoms come and go, or are they constant?
What activities or positions make your symptoms worse?
What, if anything, seems to improve your symptoms?
Do you have any other medical conditions?
Have you ever had any injuries to your feet or ankles?
Do you take any medications?

Questions to ask your clinician about your arch pain

What is the most likely cause of my symptoms?
What are other possible causes for my symptoms?
What tests do I need to get a diagnosis?
How will you treat this condition?
What are the potential risks and side effects of the recommended treatment?
I have other health conditions. How can I best manage them together?
Are there any restrictions that I need to follow?
Is there anything else I can do to relieve my symptoms or prevent further injury?
What happens if my condition does not improve with treatment?
What other options do I have?

Conclusion

Foot arch pain is a common problem that can cause significant discomfort. Several factors, including structural issues, muscle tightness, and injury, can cause the condition. Treatment options vary depending on the underlying cause of the pain. However, they may include rest, ice, compression and elevation (RICE), physical therapy, orthotics and surgery.

Simple exercises can sometimes stretch and strengthen the muscles and ligaments around the foot to prevent pain. Wearing supportive shoes and avoiding activities that place repetitive stress on your feet can help prevent foot arch pain.

If You Are experiencing discomfort in your feet, consult your podiatrist to develop a treatment plan that works best for you. Remember, your health is wealth, so always seek professional help. You may also find navicular drop interesting. Regards.

Resources

1. National Institute of Arthritis and Musculoskeletal and Skin Diseases: https://www.niams.nih.gov/

2. American Academy of Orthopaedic Surgeons: https://www.aaos.org/

3. Podiatry Today: https://www.podiatrytoday.com/

4. Ortho Info: https://orthoinfo.aaos.org/en/diseases–conditions/arch-pain-plantar-fasciitis-and-heel-spurs/

5. Royal College of Podiatry: https://rcpod.org.uk/

6. American Podiatric Medical Association: https://www.apma.org/index.cfm/

References

1. Na, S., Lee, D., & Song, J. (2011). The effect of magnesium sulfate on pain relief in plantar fasciitis: a randomized controlled trial. BMC Musculoskeletal Disorders, 12(1), 1-7. https://doi.org/10.1186/1471-2474-12-122

2. Wong, T., Munteanu, S., Menz, H., & Landorf, K. (2014). Effectiveness of Orthotic devices for the treatment of plantar fasciitis: A systematic review. BMC Musculoskeletal Disorders, 15(1), 1-11. https://doi.org/10.1186/1471-2474-15-356