Arch pain is a common complaint among patients who visit my podiatry office, exceeded only by heel pain. While common in athletes, even my less active patients can suffer from it. Today I’ll be discussing the causes, treatment, and prevention of arch pain.

What Causes Arch Pain?

Arch pain can come on suddenly. For example, after a run or long walk. Or it can develop slowly over time.

Understanding the cause of arch pain starts with an appreciation of the arch's function. Each foot has two arches: the medial arch on the inside of your foot and the lateral arch on the outside. These structures work to support your weight, absorb shock, and help maintain balance while allowing flexibility to prevent injury when you move. Your foot arch type is inherited and often determines the types of foot problems you’re more likely to develop.

Flat Feet Can Cause These Foot Conditions

People with flat feet are more prone to develop several different foot conditions including plantar fasciitis and Achilles tendonitis.

That’s because when the arch is flat, you’re more likely to overpronate or roll your feet in every time you walk or participate in sports. This overpronation causes stress on the plantar fascia, the ligament that runs along the bottom of your foot. When the plantar fascia is stressed, you can develop pain in your heel, arch, and Achilles tendon. Overpronation can also lead to conditions like bunions, hammertoes or overlapping toes.  

A severely collapsed arch is the hallmark of a condition called Posterior Tibial Tendonitis. Getting immediate treatment is necessary to avoid further degeneration of the arch and surgery.

High Arches Can Cause These Foot Conditions

High arches can also lead to some of the same chronic foot conditions that people with flat feet experience but for different reasons. Plantar fasciitis and Achilles tendonitis can develop because of more pressure on the heel of the foot.

In addition, having a high-arched foot can also cause a few other conditions.

  • First is metatarsalgia which is pain felt across the ball of the foot. This can be particularly problematic in people who wear high heels because of the added pressure on this area of the foot.
  • Calluses are more prone to develop on the ball and heel of the foot due to the increased pressure in those areas.
  • Those with high-arched feet can have poor ankle stability leading to an increased risk for ankle sprains.
  • High arches that aren’t properly supported can lead to arthritis of the foot.

Fortunately, there is a lot you can do to treat pain in the arch of your foot.

Treatment for Arch Pain At Home

First I’ll talk about how arch pain can be treated at home.

  • If you’re experiencing pain in the arch of your foot, limit your activities. Don’t keep working out or the pain is likely to get worse. Second, treat the inflammation. You can do this in several ways.
  • Try icing your arch 3 times a day for 10 mins. by using a bag of frozen peas or by freezing water in a Dixie cup, tearing down the sides, and then applying it.
  • Massage can also help by bringing blood to the area to help it heal.
  • If your doctor permits it, you can also take nonsteroidal anti-inflammatory medication.
  • Check your shoes. Unsupportive shoes can cause arch and heel pain. On occasion, a change of shoes is all that’s needed to treat arch pain, but more typically it’s one aspect of a whole comprehensive program to resolve it. To find out if your shoes might be the problem, check out my video “How to Test Any Shoe for Stability" below.
  • Don’t go by brand alone when purchasing your shoes. Shoe companies design shoes for many different purposes. For example, just because you have a name brand, doesn’t mean it’s appropriate for your sport.
  • Replace the insert that comes with your shoes with an over-the-counter insert such as Powerstep or Redi-Orthotics.
  • Stretching is also a very important part of recovering from arch pain for many of my patients. That’s because tight calf muscles and tight Achilles are common in people who develop arch pain. To stretch enough to make a difference I recommend my patients use an Achilles splint for 30 mins during the day in addition to doing some more traditional stretches. Check out my video below.

Treatment for Arch Pain At Your Podiatrist's Office

While you might heal from arch pain using the remedies I just described, typically most people will also need in-office treatment.

Reducing Your Inflammation

One of the keys to getting better from arch pain is reducing your inflammation and pain. While the at-home treatments can help in mild cases, if you have moderate to severe arch pain, you’ll need additional help.

Some of the in-office treatments we use to decrease inflammation and pain are:

  • An injection of cortisone- this method can drop your inflammation quickly although it can be a painful procedure.
  • Sometimes if the pain is severe we’ll provide you with a Walking boot to immobilize your foot.
  • Finally, we use MLS laser therapy. This therapy heals the pain and inflammation at the cellular level. I often recommend this to my patients who’ve had arch pain for several months or if it keeps coming back. Patients can heal up to 40% faster with this therapy.

Treating Your Abnormal Foot Mechanics

In addition to decreasing your pain, it’s also essential that we treat your abnormal foot mechanics. We use traditional custom orthotics or Custom 3D Printed Orthotics to properly align and support your feet.

I’ll assess your feet and gait by examining your feet and watching you walk. In addition, we’ll do a gait analysis with our Go4D computerized gait analyzer. This will help us distinguish between the timing and weight bearing and differences between your left and right foot through the walking cycle. We’ll use all this information to determine which orthotics are best for your condition and level of activity.

In addition, if you’re diagnosed with posterior tibial tendonitis you may be fitted with an AFO (Ankle Foot Orthotic) to keep your foot from collapsing onto the arch.

Prevention Strategies for Arch Pain 

Finally, let’s discuss how to prevent arch pain from developing or coming back.

Once you’ve healed from arch pain, you might be afraid it will return. A big key to preventing arch pain and the conditions of plantar fasciitis and Achilles tendonitis is to be sure you wear your orthotics consistently. Sometimes patients think that wearing them just when they play sports, run, or go for long walks will help keep the problem at bay. Unfortunately, that’s not the case. Wearing your orthotics all the time and wearing appropriate shoes are essential in preventing a recurrence.

If you’re an athlete, it’s important to use Dynamic stretches before you work out and static stretches afterwards. 

Also, if you’ve been away from sports for awhile, start slowly and gradually increase your distance or sports time by no more than 10% a week so your body has time to recover.

In conclusion, while many factors can put you at risk for developing arch pain, there’s a lot you can do to prevent it the first time or prevent it from coming back.