All The Things You Need To Know About Pain In The Arch
Overview
Flat feet, also known as ?fallen arches? are often viewed as problematic simply because they look abnormal, the main arch of the foot, the medial longitudinal arch, has collapsed. Though flat feet are by no means normal, they are often the result of some other underlying condition or weakness rather than a problem with the actual arch itself that has collapsed. Conventional treatment involving foot support either via supportive footwear, orthotics, or some other bracing system is usually more disadvantageous than beneficial and surgery is rarely the answer.
Causes
There are a number of possible causes for arch pain, but the most common are structural imbalances of the foot, such a pronated foot (rolls inward at the ankles). This is often not enough in isolation to cause the problem, but in combination with other factors arch pain may develop. These other factors are usually associated with overuse - running, walking, hard surfaces and/or OFAD (on feet all day), usually combined with inadequate or non-supportive footwear. The more common specific causes of arch pain can be plantar fasciitis (strain of the plantar fascia - a strong ligament that supports the arch), tarsal tunnel syndrome (a pinched nerve at the ankle that refers pain to the arch), foot strain from a pronated foot or flat foot, there can be osteoarthritis of the joints in the midfoot that can cause arch pain.
Symptoms
Intense heel pain, especially first thing in the morning and after a long day. Difficulty walking or standing for long periods without pain. Generally, the sharp pain associated with plantar fasciitis is localized to the heel, but it can spread forward along the arch of the foot and back into the Achilles tendon. While severe cases can result in chronic pain that lasts all day, the most common flare ups occur first thing in the morning, making those first steps out of bed a form of torture, and in the evening after having spent a day on your feet. Overpronation (a foot that naturally turns too far inward), high arches, and flat feet (fallen arches) can all cause similar arch pain. In these cases, however, the pain is more likely to continue throughout the day rather than being worst in the morning.
Diagnosis
A patient is asked to step with full body weight on the symptomatic foot, keeping the unaffected foot off the ground. The patient is then instructed to "raise up on the tip toes" of the affected foot. If the posterior tibial tendon has been attenuated or ruptured, the patient will be unable to lift the heel off the floor and rise onto the toes. In less severe cases, the patient will be able to rise on the toes, but the heel will not be noted to invert as it normally does when we rise onto the toes. X-rays can be helpful but are not diagnostic of the adult acquired flatfoot. Both feet, the symptomatic and asymptomatic - will demonstrate a flatfoot deformity on x-ray. Careful observation may show a greater severity of deformity on the affected side.
Non Surgical Treatment
Anti-inflammatory medications such as ibuprofen and aspirin can provide short-term relief from foot pain associated with fallen arches, notes the American Academy of Orthopaedic Surgeons. Doctors sometimes inject the foot with a corticosteroid medication, which acts as an anti-inflammatory, to relieve acute pain. Although medications can provide symptom relief, they do not correct the underlying foot abnormality.
Surgical Treatment
The procedure involves cutting and shifting the bone, and then performing a tendon transfer. First, the surgeon performs a calcaneal osteotomy, cutting the heel bone and shifting it into the correct position. Second, the surgeon transfers the tendon. Reroute the flexor digitorum to replace the troublesome posterior tibial tendon. Finally, the surgeon typically performs one or more fine-tuning procedures that address the patient?s specific foot deformity. Often, the surgeon will lengthen the Achilles tendon because it is common for the mispositioned foot to cause the Achilles to tighten. Occasionally, to increase the arch, the surgeon performs another osteotomy of one of the bones of the midfoot. Occasionally, to point the foot in a straightforward direction, the surgeon performs another osteotomy of the outside portion of the calcaneus.
Prevention
Maintain a healthy weight, Use insoles to support your arches, Limit how often you wear high heels, Use proper shoes, especially when exercising to evenly distribute weight through your foot.
Flat feet, also known as ?fallen arches? are often viewed as problematic simply because they look abnormal, the main arch of the foot, the medial longitudinal arch, has collapsed. Though flat feet are by no means normal, they are often the result of some other underlying condition or weakness rather than a problem with the actual arch itself that has collapsed. Conventional treatment involving foot support either via supportive footwear, orthotics, or some other bracing system is usually more disadvantageous than beneficial and surgery is rarely the answer.
Causes
There are a number of possible causes for arch pain, but the most common are structural imbalances of the foot, such a pronated foot (rolls inward at the ankles). This is often not enough in isolation to cause the problem, but in combination with other factors arch pain may develop. These other factors are usually associated with overuse - running, walking, hard surfaces and/or OFAD (on feet all day), usually combined with inadequate or non-supportive footwear. The more common specific causes of arch pain can be plantar fasciitis (strain of the plantar fascia - a strong ligament that supports the arch), tarsal tunnel syndrome (a pinched nerve at the ankle that refers pain to the arch), foot strain from a pronated foot or flat foot, there can be osteoarthritis of the joints in the midfoot that can cause arch pain.
Symptoms
Intense heel pain, especially first thing in the morning and after a long day. Difficulty walking or standing for long periods without pain. Generally, the sharp pain associated with plantar fasciitis is localized to the heel, but it can spread forward along the arch of the foot and back into the Achilles tendon. While severe cases can result in chronic pain that lasts all day, the most common flare ups occur first thing in the morning, making those first steps out of bed a form of torture, and in the evening after having spent a day on your feet. Overpronation (a foot that naturally turns too far inward), high arches, and flat feet (fallen arches) can all cause similar arch pain. In these cases, however, the pain is more likely to continue throughout the day rather than being worst in the morning.
Diagnosis
A patient is asked to step with full body weight on the symptomatic foot, keeping the unaffected foot off the ground. The patient is then instructed to "raise up on the tip toes" of the affected foot. If the posterior tibial tendon has been attenuated or ruptured, the patient will be unable to lift the heel off the floor and rise onto the toes. In less severe cases, the patient will be able to rise on the toes, but the heel will not be noted to invert as it normally does when we rise onto the toes. X-rays can be helpful but are not diagnostic of the adult acquired flatfoot. Both feet, the symptomatic and asymptomatic - will demonstrate a flatfoot deformity on x-ray. Careful observation may show a greater severity of deformity on the affected side.
Non Surgical Treatment
Anti-inflammatory medications such as ibuprofen and aspirin can provide short-term relief from foot pain associated with fallen arches, notes the American Academy of Orthopaedic Surgeons. Doctors sometimes inject the foot with a corticosteroid medication, which acts as an anti-inflammatory, to relieve acute pain. Although medications can provide symptom relief, they do not correct the underlying foot abnormality.
Surgical Treatment
The procedure involves cutting and shifting the bone, and then performing a tendon transfer. First, the surgeon performs a calcaneal osteotomy, cutting the heel bone and shifting it into the correct position. Second, the surgeon transfers the tendon. Reroute the flexor digitorum to replace the troublesome posterior tibial tendon. Finally, the surgeon typically performs one or more fine-tuning procedures that address the patient?s specific foot deformity. Often, the surgeon will lengthen the Achilles tendon because it is common for the mispositioned foot to cause the Achilles to tighten. Occasionally, to increase the arch, the surgeon performs another osteotomy of one of the bones of the midfoot. Occasionally, to point the foot in a straightforward direction, the surgeon performs another osteotomy of the outside portion of the calcaneus.
Prevention
Maintain a healthy weight, Use insoles to support your arches, Limit how often you wear high heels, Use proper shoes, especially when exercising to evenly distribute weight through your foot.
