For the appropriate management of arch pain, it is essential first to establish the cause of the pain, which will enable the optimal treatment decision and techniques. Management may then include a combination of physical therapy, additional foot support and pharmacotherapy to manage the pain and prevent recurrence.

Determining the Cause

There are many possible causes of arch pain, and the likely causes of an individual case should be determined to allow the ideal treatment to take place. This may be done by a consultation with the patient about possible causative circumstances, a physical examination and other diagnostic tests.

Common causes of arch pain include:

• Muscle or ligament strains or sprains
• Biomechanical misalignment
• Mechanical stress or overuse
• Inflammatory arthritis
• Foot deformity
• Weight changes
• Unsupportive footwear

Individuals who are obese are more likely to suffer from symptoms of arch pain, as their feet are placed under more stress on a continuous basis due to the excess body weight. Light, regular exercise can help them to reach a healthier body weight, which can reduce symptoms of arch pain, in addition to other health benefits.

Similarly, if the condition is caused by intense physical activity that causes excessive stress to the feet of the individual, it may be appropriate to moderate or alter participation in these activities. For example, running places significant stress on the arch of the feet, but other activities such as cycling or swimming are much less likely to cause issues.

Physical Therapy

Physical therapy is often one of the primary components in the overall management of arch pain, as the most common cause of arch pain is associated with injury and inflammation of the connective tissue in the arch of the foot.

Initially for foot injuries, the RICE (rest, ice, compression, elevation) protocol should be followed. Massage therapy can then be introduced help to increase the circulation to the area and promote the healing process.

Patients will also usually be given specific exercise to practices on a regular basis that are designed to strengthen and increase the stability and flexibility of muscles in the foot. Splints worn at nighttime while sleeping can also help to stretch the foot and improve flexibility. This helps to prepare the feet to meet the demands of the body and prevent or reduce the recurrence of foot arch pain.

Foot Support

Supportive footwear with a strong sole and arch support can help to prevent inflammation and pain in the arch of the foot.

This is particularly useful for individuals that participate in sports or are required to spend long hours on their feet, such as throughout the workday. Additionally, athletic shoes may reduce in elasticity with time and should be replaced every six months with intense usage for athletes.

For some individuals, custom fabricated orthotics may be the best option to support the foot and improve the biomechanics of foot movements.

Pharmacotherapy

For immediate relief of the pain in the arch of the foot, simple analgesic medications may be used. This includes paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, aspirin or diclofenac.

However, it should be noted that these treatment techniques help to reduce the immediate pain but do not address the cause of the pain or help to prevent recurrence. For this reason, pharmacological treatment techniques should be paired with physical therapy or other treatment methods.

Prevention of Symptom Recurrence

It is important for people that are likely to be affected by arch pain take appropriate measures to improve the strength of their foot arch and prevent the recurrence of symptoms.

This may include regular stretching or exercises to improve strength, flexibility and stability and appropriate footwear to support foot movement. A podiatrist can help by recommending appropriate shoes and exercises that can be used to prevent pain in the arch of the foot.

References

• http://www.footvitals.com/sole/arch-pain.html
• https://www.nlm.nih.gov/medlineplus/ency/article/007021.htm
• http://www.aafp.org/afp/2001/0201/p467.html
• http://www.emedicinehealth.com/arch_pain/page7_em.htm#arch_pain_treatment

Further Reading

• All Foot Content
• Foot Pain Management
• Living with Foot Pain
• Flexible vs Rigid Flat Foot
• Flatfoot in Children

Written by

Yolanda Smith

Yolanda graduated with a Bachelor of Pharmacy at the University of South Australia and has experience working in both Australia and Italy. She is passionate about how medicine, diet and lifestyle affect our health and enjoys helping people understand this. In her spare time she loves to explore the world and learn about new cultures and languages.