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 Feet burning? Arches aching? Feet are sore when standing on hard floors or for long periods of time? Do you feel like your arches are ripping?  Sounds like a "pain in the arch!"

Arch pain, which is also  known as plantar pain is a broad term many people use to describe pain in their muscles, tendons, ligaments, bones, or nerves in the arch of the foot. All these components are connected to the bottom of the foot; therefore, damage to any one of these can cause pain. This pain may only last for short time, but can progressively worsen if untreated. Most people who suffer from this pain are between the ages of 30 and 80, but many younger athletes are also susceptible, particularly those who participate in high-impact sports, such as basketball, volleyball or running. 

Arch Pain Symptoms

You should seek help at the first sign of symptoms. The sooner they can be treated, the faster you will recover.  Besides pain on the bottom of the foot, additional symptoms may include:

Burning sensation in arch
Difficulty standing on tiptoes
More pain after sleeping or resting
tissues warm to the touch
Pain that increases when toes are flexed
Aching and overall soreness
Pain that increases when walking barefoot
Pain that increases when walking on hard surfaces
Pain the increases when standing (putting weight on your feet) or moving around and decreases when immobile
Skin Lesions (corns and calluses on the sole of your foot)

It’s important to get a proper diagnosis and treatment plan. Let’s go over the possible causes of the pain.

Arch Pain Causes

There are several reasons why pain in the arches can develop. It could be due to a condition known as plantar fasciitis, in which the plantar fascia (the band of fibrous, non-elastic  tissue that runs along the bottom of your foot) 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 bottom 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, as it chanes the overall joint mechaincs of the foot.  Medical conditions such as diabetes or obesity can put additional stress on your feet, thereby causing bottom-of-foot pain. 

Occasionally a large nerve in the foot can get "trapped". This can produce symptoms of sharp, shooting pain or intense radiating pain through the midsection of the foot. It can also feel like your feet are burning all of the time. It may produce no symptom one minute, then feel like a knife stabbed in the top of your foot the next. This is a problem called tarsal tunnel syndrome or tarsal nerve entrapment. It most often happens in people with a "flat" or over-pronated foot. It can be similar to carpal tunnel syndrome in the wrist, only in the small bones of the feet.

 The footwear you choose 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, pregnant, or play a lot of sport type 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 bottom-of-foot pain.


 Diagnosing Arch Pain

To come to a correct diagnosis, your foot specialist will examine your feet physically to assess any skin problems.  He or she will also examine your foot to look for deformities such as high or low arches, or to see if you have hammertoes, bunions etc.   He/ she will also inquire about your daily activities, symptoms, footwear, medical history, and family history.

 If you spend a lot of time running or jumping, you may be at a higher risk for pain in the bottom of your foot. 

Arch Pain Treatment

How the pain in the bottom of your foot is treated will depend heavily on the cause of the pain. Diagnosing the pain while it’s in the early stages is important when determining the best treatment options.

 If the pain is mild to moderate, simple improvements in footwear can help reduce the symptoms. Most patients must use the RICE method for effective treatment. RICE stands for Rest, Ice, Compression, and Elevation. . It involves resting the foot, icing it for fifteen to twenty minute intervals, compressing the foot with a bandage if possible, and elevating it at least twelve inches above the heart. Ant-inflammatory and pain medications are also sometimes used to treat bottom-of-foot pain. Physical therapies such as laser/ ultrasound and shockwave treatment are also helpful in treating arch pain.

For more serious cases, steroid injections or foot surgery may help reduce pain and swelling, and correct the underlying condition (if there is one.) If you suffer from a severe case of plantar fasciitis and non-surgical methods fail, your doctor may recommend cortisone injections to relieve the pain. 

Some  stretching exercises that may assist in treating arch pain include:

Plantar Fascia Stretch: While seated, cross your legs at the knee with the affected foot on top of the other foot. On the painful foot, grab the toes and pull them toward you slowly with your hand on the plantar fascia. Hold this position for ten seconds and repeat twenty times.

Foot Flexing: This exercise is recommended before getting out of bed (when the pain from plantar fasciitis is most commonly felt). Hold this position for ten seconds and repeat twenty times.

Rolling Stretch: At first this exercise should be done while seated, either on a chair or at the edge of your bed. Roll a tennis ball or a rolling pin back and forth ten times, with the arch of one foot, then switch feet and repeat. Once you have practiced this for a while, begin doing it while standing.

If there is determined to be an underlying structural cause of the arch pain which is putting increased stress on the soft tissue, a custom orthotic is often used to control the joints in the foot so that the foot may function properly, and therefore alleviate the stress on the soft tissues.

Preventing Arch Pain

There are several things you can do to prevent pain on the bottom of the foot. Here are some tips to help you avoid this condition:

Do simple stretches each day
Wear good shoes that fit properly and are appropriate for the activity you are participating in, and are in good condition.
Lose excess weight if possible.
Build your stamina slowly, especially with new exercises.
Rest and elevate your feet, whenever possible to promote healing.
Try not to do the same activity every day for sports. Cross train. If you run one day, ride your bike or swim the next day. Swimming is great exercise and puts very little stress on joints and overused soft tissues.