Arch Pain Causes and Treatments

Arch pain is the term used to describe symptoms that occur under the arch of the foot. When a patient has arch pain they usually have inflammation of the soft-tissues within the midfoot. The arch of the foot is formed by a tight band of tissue that connects the heel bone to the toes called the plantar fascia.

This band of tissue is important in proper foot mechanics and transfer of weight from the heel to the toes. When the tissue of the arch of the foot becomes irritated and inflamed, even simple movements can be quite painful.

Arch pain causes

Illustration by Nusha Ashjaee, Verywell

Causes

Plantar Fasciitis

The most common cause of arch pain is plantar fasciitis. Plantar fasciitis is the name that describes inflammation of the fibrous band of tissue that connects the heel to the toes.

Symptoms of plantar fasciitis include pain early in the morning and pain with long walks or prolonged standing. Arch pain early in the morning is due to the plantar fascia becoming contracted and tight as you sleep through the night.

When awakening and walking in the morning, the fascia is still tight and prone to irritation when stretched. When walking or standing for long periods, the plantar fascia becomes inflamed and painful.

Treatment of plantar fasciitis is best accomplished with some simple stretching exercises, anti-inflammatory medications, and inserts for your shoes.

Stress Fractures

The bones that are in the midfoot (including the navicular, cuboid, and cuneiform bone) and the metatarsal bones can all be damaged by overuse. When this occurs, a stress fracture is a possible injury to the bone.

Stress fractures occur not as the result of a single injury, but rather repetitive overuse that eventually leads to a crack forming in the bone.

Stress fractures typically cause pain that worsens with increased activity. Unlike plantar fasciitis that can loosen with some activity, the pain associated with a stress fracture typically worsens as activity levels increase.

When a stress fracture occurs the bone needs rest. In some situations, a walking boot can lead to effective relief, whereas in other situations all weight must be relieved from the bone requiring crutches.

Ligament Sprains

There are 26 bones in each foot, all of which are connected by an intricate web of ligaments. These ligaments can be injured by twisting or landing awkwardly while walking or running.

Ligament injuries typically occur after an unusual foot movement and cause immediate pain. Swelling may also occur.

Most ligament sprains will improve with rest. Sometimes immobilizing the foot can help with treatment. In some rare situations, surgery may be needed for treatment. One such ligament injury is called a Lisfranc sprain of the midfoot.

Tendonitis

Inflammation of the tendons that pass along the foot can also cause pain in the arch. The two most commonly injured tendons that cause arch pain are the tibialis posterior and the peroneal tendons.

These tendons start in the leg, course behind the ankle, and then to the underside of the foot. Both tendons are important at controlling movements of the foot and ankle.

When to See a Healthcare Provider

Most often arch pain is not a serious medical problem, but there are times that evaluation by a medical professional is necessary. Some of the signs that you should see a healthcare provider include:

  • Inability to bear weight on the extremity
  • Worsening symptoms that do not respond to simple treatment
  • Signs of infection (fever, chills, redness around the arch)

Diagnosis of arch pain can typically be made with a careful examination of the foot. Evaluating the alignment of the foot, structure, and ligamentous support can all be performed by medical examination.

If there are concerns about the structure or stability of the foot, special tests may be performed for further evaluation. X-rays can give a useful assessment of the alignment of the bones of the foot. Tests including computerized tomography (CT) scans and magnetic resonance imaging (MRI) may be necessary for further evaluation.

Treatment and Prevention

Treatment of arch pain generally consists of relieving pressure from the irritated area on the bottom of the foot, and efforts to control swelling and inflammation. Some of the simple steps that you can begin with include:

  • Rest: Resting the affected extremity is critical in order to reduce inflammation within the arch of the foot. This may require changes in activities, or even the use of crutches.
  • Ice application: Applying ice to the affected area can be a helpful way to control inflammation and also reduce pain. Many people find ice massage an effective method to apply cold treatment to this area.
  • Anti-inflammatory medications: Nonsteroidal anti-inflammatory medications are effective medications to relieve discomfort associated with inflammation. Make sure you check with your healthcare provider before beginning any new medication.
  • Footwear modifications: Changes in footwear with more arch support, better cushioning, or other changes can often be helpful. Wearing supportive footwear is essential when managing arch pain.

Once the symptoms of arch pain have been effectively controlled, it is also important to ensure they do not return as soon as the treatment is completed. Ensuring proper fitting footwear with good support can be one helpful step.

In addition, gradual resumption of activity should be carried out in the early stages following an episode of arch pain.

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Click Play to Learn How to Use Ice for Plantar Fasciitis

This video has been medically reviewed by Casey Gallagher, MD

A Word From Verywell

Arch pain is a frequent complaint and typically from one of a few common conditions. Fortunately, most people with arch pain can find effective relief of symptoms with a few simple steps.

If these are not effective, seeing your medical provider can help to ensure there is not a more serious problem that is causing your symptoms. Once people have arch pain, they should take steps to prevent the recurrence of this problem.

Frequently Asked Questions

  • Can stretches relieve pain in the arch of your foot?

    Yes. Stretches especially help if the pain is from tightness in the tissue that connects the heel bone to the toes (plantar fasciitis). Moves targeting this area include curling the toes and the heel towards the center of the foot and rolling the arch over a ball. Stretches that target the Achilles tendon may also provide relief.

  • Can flat feet cause arch pain?

    In some instances, yes. While most people with flat feet have no symptoms, you may have pain and problems standing or bearing weight. The pain is often in the middle of the foot, but tightness could cause arch pain as well.

  • Why does my arch hurt when I walk?

    A number of factors can cause this type of pain including an injury to the bone or ligaments or inflammation of tendons. These may be caused by sports or overuse. An unusually high arch (cavus foot) can also cause pain when walking.

8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. Muth CC. Plantar fasciitis. JAMA. 2017;318(4):400. doi:10.1001/jama.2017.5806

  3. Kahanov L, Eberman LE, Games KE, Wasik M. Diagnosis, treatment, and rehabilitation of stress fractures in the lower extremity in runners. Open Access J Sports Med. 2015;6:87-95. doi:10.2147/OAJSM.S39512

  4. Mulcahy H. Lisfranc Injury: Current Concepts. Radiol Clin North Am. 2018;56(6):859-876. doi:10.1016/j.rcl.2018.06.003

  5. Federer AE, Steele JR, Dekker TJ, Liles JL, Adams SB. Tendonitis and tendinopathy: What are they and how do they evolve?. Foot Ankle Clin. 2017;22(4):665-676. doi:10.1016/j.fcl.2017.07.002

  6. Sweeting D, Parish B, Hooper L, Chester R. The effectiveness of manual stretching in the treatment of plantar heel pain: a systematic review. Journal of Foot and Ankle Research. 2011;4(1). doi:10.1186/1757-1146-4-19

  7. Aenumulapalli A, Kulkarni MM, Gandotra AR. Prevalence of flexible flat foot in adults: a cross-sectional study. J Clin Diagn Res. 2017;11(6):AC17-AC20. doi:10.7860%2FJCDR%2F2017%2F26566.10059

  8. Children’s Hospital of Philadelphia. Cavus Foot

Additional Reading

By Jonathan Cluett, MD
Jonathan Cluett, MD, is board-certified in orthopedic surgery. He served as assistant team physician to Chivas USA (Major League Soccer) and the United States men's and women's national soccer teams.