Pain in the arch of your foot is often triggered by plantar fasciitis. But if you've already ruled that out as a possibility and are still experiencing discomfort, what else might the culprit be?
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"Plantar fasciitis is the most common cause of foot arch pain," says Kenneth Jung, MD, foot and ankle surgeon at the Cedars-Sinai Kerlan-Jobe Institute in Los Angeles. It's often marked by a stabbing pain in the bottom of the foot, near the heel, and tends to be most noticeable when you first wake up or after sitting for long periods, per the Mayo Clinic.
But injuries and other foot problems can cause similar (though not always identical) symptoms, and getting to the root cause can help you take the necessary steps to feel better.
Here are five more things that can cause foot arch pain besides plantar fasciitis, what to do about them and when to consider seeing a doctor.
1. Tendon Dysfunction
Inflammation of the posterior tibial tendon — the tendon connecting the calf muscle to the inside of the foot — can cause pain and swelling along the inside of the foot, around the arch. It tends to get worse with walking or running and can make it harder to stand on your toes or walk up and down stairs, according to the Cleveland Clinic.
The problem can develop from a foot injury, but it can also be the result of age-related wear and tear.
Fix it: Rest, ice and over-the-counter pain medications may be enough to ease the inflammation.
In some cases, wearing a cast or walking boot for six to eight weeks may be needed to give the tendon a chance to become less swollen; physical therapy can help strengthen the tendon and keep the problem from worsening, per the American Academy of Orthopaedic Surgeons (AAOS).
2. Heel Bone Fracture
Another injury that can lead to pain in the arch of the foot is a bruised or fractured heel, Dr. Jung says.
It can happen when the heel experiences sudden crushing or jarring, like from a fall or a car crash. The area will typically become bruised or swollen, and while the pain might not be severe enough to stop you from walking, it's usually bad enough to cause a limp, according to the AAOS.
Fix it: Treatment often involves wearing a splint, resting, applying ice and keeping the foot elevated, then applying a cast once the swelling goes down, according to Merck Manuals. Surgery may be needed for severe fractures that involve the ankle joint.
3. High Arches
Having high arches, sometimes called cavus foot, puts more stress on the arch of the foot. This can cause pain (especially when standing or walking) and lead to corns or calluses on the balls or sides of the feet.
High arches can be genetic, and many people are simply born with them, according to the Cleveland Clinic. You can tell if you have them by wetting your feet and standing on a dry surface (like concrete or a piece of paper). If the imprint left behind only shows your heel and the front of your foot, you have high arches.
Fix it: High arches are typically managed with orthotics, shoe inserts that give your feet extra cushioning and stability. Sometimes over-the-counter inserts can do the trick, but custom pairs will usually provide better support.
Braces can provide more stability in severe cases, as can surgery, notes the American College of Foot and Ankle Surgeons.
It's important to note here that having high arches puts you at risk for developing plantar fasciitis, which is why supporting your feet is so important.
4. Flat Feet
While high arches can cause pain in the bottom of your foot, so too can arches that are too low — or nonexistent. Sometimes flat feet are the result of an injury, but they can also be a result of aging or of health problems like obesity or diabetes, per the Mayo Clinic.
Flat feet don't always cause symptoms, but in some cases, they can trigger discomfort or swelling in the heel or foot arch that tends to get worse when you're active.
Fix it: Orthotics won't cure flat feet, but they can help relieve discomfort or swelling, according to the National Institutes of Health (NIH). At-home exercises like calf muscle stretches, which you can learn from a physical therapist, can also make a difference, as can wearing supportive shoes. Surgery may also be an option if lifestyle changes aren't enough.
Like high arches, having flat feet puts you at risk for developing plantar fasciitis, so investing in good foot support — especially if you're active — is a good idea.
Overpronation occurs when the foot rolls downward and inward while walking or running, causing the arch of the foot to collapse. It often occurs in tandem with flat feet, Dr. Jung points out, and can place stress on the tendons that run along the arch of the foot.
Because overpronation usually occurs alongside flat feet, the symptoms tend to be similar. Overpronation can also make you more prone to foot injuries that can cause arch pain or worsen pain that already exists, per the AAOS.
Fix it: Orthotics and supportive shoes can help correct overpronation, Dr. Jung says.
If the overpronating has led to or exacerbated an injury, physical therapy or wearing a walking boot or brace may be needed to help the injury heal.
When to See a Doctor for Foot Pain
See your doctor or a podiatrist for foot arch pain that doesn't ease up with icing and a few days of taking it easy. Your provider can examine your foot and help you put together a treatment plan that will typically start with conservative measures.
"Months of physical therapy may be indicated and orthotics may be prescribed," Dr. Jung says. "The great news is that non-operative treatment is usually successful."
- Mayo Clinic: "Plantar fasciitis"
- Cleveland Clinic: "Posterior Tibial Tendon Dysfunction (PTTD)"
- American Academy of Orthopaedic Surgeons: "Posterior Tibial Tendon Dysfunction"
- American Academy of Orthopaedic Surgeons: "Calcaneus (Heel Bone) Fractures"
- Merck Manual: "Fractures of the Heel Bone"
- American College of Foot and Ankle Surgeons: "Cavus Foot (High-Arched Foot)"
- Mayo Clinic: "Flatfeet"
- National Institutes of Health: "Flat feet"
- American Academy of Orthopaedic Surgeons: "Walking and pronation"
Is this an emergency? If you are experiencing serious medical symptoms, please see the National Library of Medicine’s list of signs you need emergency medical attention or call 911.