Anatomy: There is a band of tissue that connects the heel to the base of your toes called the "Plantar Fascia" this is fan shaped at its attachment to the base of the toes and forms the main structural component of your arch. The Plantar Fascia is important to the mechanics and control of your gait as we transfer weight from the heel to the toe. When this area becomes inflamed it can cause a lot of pain in the foot with even simple motion.
The most common culprit in the type of pain we are discussing is in fact termed "Plantar fasciitis." This is a catch all term for inflammation in the bottom of the foot from the heel to the toes. Often times this is worst early in the morning and can be exacerbated by prolonged standing or long walks.
There are other common causes of arch pain such as:
- Improper mechanical alignment
- Stress fractures
- Ligament sprains
- Muscle strains
The symptoms of arch pain may range can run from a minor annoyance to total incapacitation and inability to do ones normal range of activities without pain. Symptoms of arch pain may include some or all of the following:
- Pain and tenderness on the bottom of the foot
- Point tenderness
- Loose joints
- Pain when working the foot against resistance
In the early stages of arch pain the most common treatment is the old adage "R.I.C.E." which stands for rest, ice, compression and elevation. Rest is self explanatory. The instructions for icing would be fifteen minutes of ice two hours between applications as many times a day as you can stand it. Compression would be a compression stocking or ace bandage, not so tight as to affect circulation. You check this by pinching the toenail for fifteen seconds, when you release them the toenail should be blanched. You want to see it return to its normal color within seconds. Elevation is placing the foot above heart level which will help with vascular drainage and swelling. One can try an over the counter anti-inflammatory but these don't tend to be very effective for this type of condition.
And of course big surprise here, custom orthotics more often than not help arch pain by correcting the mechanical changes that take place due to gravity, age, and the stresses we place on our bodies. (Yes athletes this is you, and those of us who work on our feet for prolonged periods as well.)
Needless to say you can guess which way I have gone myself, and as a result, taken many patients there with me. The joys of orthotics on our aching feet.