Pain in the arch of the foot can be caused by a number of underlying conditions. Plantar fasciitis is the most common, but other causes may include posterior tibial tendon dysfunction, cavus foot, and more.
Overview Arch pain is a common foot concern. It affects runners and other athletes, but it can also occur in people who are less active. The arch of the foot stretches from the base of your toes to your heel, and plays an important role in any activity where you’re on your feet. The arch helps:
adapt to changes in terrain
Arch pain may be felt in the ball and heel of the foot. You may also feel pain in the top of your foot, or even in your ankles, knees, hips, legs, and back. Depending on the underlying cause, the pain may be worse when walking or standing, or during or after activities involving your feet. It may also be more intense in the morning when you wake.
Arch pain can occur if you injure the muscles, bones, ligaments, or tendons that form the arch of your foot. It can also occur due to structural issues, especially if those structural issues become aggravated by:
Flat feet and high arches are examples of structural issues that may lead to arch pain. The following are common conditions that can cause arch pain:
Plantar fasciitis Plantar fasciitis is the most common cause of arch pain and one of the most common orthopedic complaints reported. It’s caused by inflammation, overuse, or injury to the plantar fascia. The plantar fascia is the ligament that connects the front of your foot to your heel. It’s often seen in runners, but it can also occur in nonrunners. If you have plantar fasciitis, you may feel pain and stiffness in the heel and arch. Pain is typically worse upon awakening and becomes more painful after prolonged standing or activities where you’re on your feet.
If you frequently experience plantar fasciitis, you may need to wear a different type of shoe or get inserts to provide additional comfort and support to your foot. Stretches can also help relieve pain from plantar fasciitis.
Posterior tibial tendon dysfunction (PTTD) PTTD, also known as adult-acquired flatfoot, occurs when you have an injury or inflammation to the posterior tibial tendon. The posterior tibial tendon connects the inner foot to a muscle in the calf. PTTD can cause arch pain if the posterior tibial tendon is no longer able to support the arch.
With PTTD, arch pain is likely to extend along the back of the calf and inner aspect of the ankle. You may also have ankle swelling. Pain typically occurs during activities, such as running, not afterward.
You may need to wear an ankle brace or custom shoe insert to treat PTTD. Physical therapy may also help. In some cases, you may need surgery to treat the condition.
Overpronation Overpronation is used to describe the way your foot moves when you walk. In people who overpronate, the outer edge of the heel hits the ground first, and then the foot rolls inward onto the arch. This overly flattens the foot. Over time, overpronation can damage muscles, tendons, and ligaments, and cause problems that lead to arch pain. If you overpronate, you may also experience:
knee, hip, or back pain
corns or calluses
You may also notice extra wear on the inside part of the bottom of your shoe, specifically on the inside of the heel and the ball of the foot.
If you overpronate, you may want to consider stability shoes. These shoes help correct your step when you walk. Inserts may also help. Ask a store associate at a local shoe store for recommendations, or talk to a podiatrist or orthopedic surgeon. A podiatrist is a doctor who specializes in foot health. Exercises and stretches may also help.
Cavus foot Cavus foot is a condition where the foot has a very high arch. It may be an inherited structural abnormality, or it could be caused by neurological conditions, like cerebral palsy, stroke, or Charcot-Marie-Tooth disease. Pain is most commonly felt in people with cavus foot when walking or standing. Other symptoms may include:
You may also be more prone to ankle sprains because of foot instability. As with other arch conditions, special orthotic shoe inserts may help relieve your pain. You may also want to wear shoes with extra ankle support, especially when participating in sports. Look for high-topped shoes. In some cases, you may need surgery. When should you see a doctor? Occasional arch pain is typically no cause for concern. In these cases, you may be able to find relief from home remedies, like soaking your foot, massage, or rest. If you frequently experience pain, of if the pain doesn’t improve or gets worse with home remedies, talk to your doctor. Arch pain can progress to more serious foot condition, and may even lead to damage in your back, knees, and ankles. If you have diabetes, it’s especially important to stay on top of foot injury or pain.
Diagnosis Your doctor will assess your medical history and conduct a physical examination to pinpoint the location of your pain. They will likely ask you to flex and point your foot while pushing on the ligament. Your doctor will also look for any signs of inflammation like redness or swelling. Your reflexes, coordination, balance, and muscle tone will all be checked.
Diagnostic testing may include:
Understanding when and where you experience arch pain could be key to your diagnosis.
Home remedies You may be able to relieve your arch pain on your own at home or with some minor lifestyle changes. In some cases, home remedies may need to be used in addition to medical treatment.
Rest When you first notice the pain, rest your foot and take a break from activities that put a lot of stress on your feet, like running or sports with a lot of jumping, such as basketball. You may need to avoid strenuous activities for a few days, or longer if the pain persists. You may also try icing your foot. Apply ice to your foot 10–15 minutes twice a day, until pain subsides.
Stretch If you suspect plantar fasciitis, you can try this self-release stretch:
Place your ankle on your thigh and cradle your toes in one hand.
With the other hand, gently fold the foot in on itself by pushing down and in on the heel.
Gently push the toes toward the heel, and hold for 3–5 minutes.
Do this once a day, or whenever you experience pain.
Here’s an easy stretch you can do at work. You’ll need a lacrosse ball, which you can find online or at a sporting goods store. You can also use a foam roller, water bottle, or tennis ball.
Sitting in a chair, remove your shoe.
Place a lacrosse ball under the ball of your foot.
Roll the ball using your foot, slowly moving the ball down your foot and to the arch. Continue rolling the ball under your foot to massage the area.
Do this for 5–10 minutes.
Stretching your calves can help relieve tightness or pain in your feet, including the arches. To stretch your calves:
Stand about an arm’s length from a wall. Facing it, place your hands on the wall.
Place your right foot behind your left.
Keep your right knee straight and your right heel on the floor as you slowly bend your left leg forward.
You should feel a stretch in your right calf. Hold the stretch for 15–30 seconds and then release.
Repeat three times on the right side, and then switch legs.
Try over-the-counter (OTC) remedies Over-the-counter arch supports and supportive shoes may help reduce pain and prevent injury in the future. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin), may also help reduce inflammation and pain.
Avoid unsupportive footwear Walking barefoot or wearing unsupportive shoes, such as flip-flops, may aggravate pain and make your condition worse. If you usually go barefoot around the house, consider getting supportive shoes that you can wear around the house, instead.
How will your doctor treat your arch pain? Your doctor may recommend additional treatments depending on your diagnosis. Treatments may include:
prescribed supportive shoes with specially designed shoe inserts or arch supports, or customized foot orthotics
prescription-strength NSAIDs or cortisone injections
Your doctor may recommend that you lose weight and temporarily refrain from certain physical activities, like prolonged standing, running, or high-impact sports.
Recovery The amount of time it takes to recover depends on the underlying cause of your arch pain. It may take 3–12 months to recover from conditions like plantar fasciitis, even with treatment. If surgery is necessary, it may take a year after the surgery to get back to your normal. It may be necessary to wear a cast for weeks or months. If your doctor prescribes orthotics, you may need to wear them indefinitely.
How can you prevent arch pain? Many of the home remedies for arch pain can also be used to help prevent pain from returning.
Wear supportive shoes with shoe inserts or arch supports, and avoid going barefoot or wearing unsupportive shoes, like flip-flops. Wearing unsupportive footwear on hard surfaces for prolonged periods creates many of the conditions that lead to arch pain.
Stretch. Begin a regular regimen of stretching exercises. Stretching your calves and the rest of your legs can help your feet, too, so don’t forget to include these areas. Invest in anti-fatigue mats. If you regularly stand in the same spot for extended periods of time, these mats can help reduce your risk for foot pain. Consider putting one on the floor in front of your kitchen sink if you spend a lot of time doing dishes. If you have a standing desk, get one for work, too.
Takeaway Arch pain is often a symptom of an underlying condition affecting your foot. Left untreated, it could become chronic or long-term. It’s important to see your doctor and begin treatment if the arch pain persists for more than a few days. Isolating the cause is the first step toward finding the cure.