Arch Pain

Causes and Treatment of Arch Pain

arch pain
Arch pain is a common location for foot discomfort. Henrik Weis / Getty Images

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.

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.

Stress Fractures

The bones the are in the midfoot (including the navicular, cubiod, and cuniform 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 increasing 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.

Sprains of Ligaments

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.  Sometime 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.


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.

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