Foot Arch Pain

Author: Chloe Wilson - BSc(Hons) Physiotherapy

Foot arch pain, or pain on the bottom of the foot, can be caused by a number of problems. It is a common when standing, walking or running for long periods.  This is often due to weakness and tightness is the muscles and tendons which support the foot which changes the way the forces go through the foot, resulting in pain. 

Pain on the bottom of the foot is also common if there is a problem in the foot arches themselves. The arches of the foot support the foot and control how the forces associated with activities like walking are transferred up and down the leg. 

If there is a problem with the foot arches such as flat feet or surrounding soft tissues e.g. the muscles of tendon, pain can be felt anywhere from the foot, to the knee, to the lower back. 

Here, we look at the ten most common causes of foot arch pain and why they cause pain on the bottom of the foot.

Plantar fasciitis is one of the most common causes of foot arch pain

Plantar fascia problems are a common cause of pain on the bottom of the foot. The plantar fascia is a thick, fibrous band which runs along the sole of the feet. It helps to support the foot arches and transmits forces through the foot as you move. 

The most common problem to develop here is plantar fasciitis.  If there is too much strain on the plantar fascia (e.g. from long periods on your feet, suddenly increasing activity levels or your foot position is altered), the plantar fascia becomes inflamed and swollen.

It is often accompanied by a bone spur, excess growth of the bone which develops due to repeated tension on the area where the plantar fascia attaches to the bone. 

Plantar fasciitis is one of the most common causes of foot arch pain.  It is usually painful after activity or prolonged rest e.g. first thing in the morning.  Find out more including how to treat and prevent the condition in the Plantar Fasciitis section.

A less common problem with the plantar fascia which causes foot arch pain is plantar fibromatosis.  This is when a small nodular growth develops on the plantar fascia, usually in the middle of the foot arch.  It often causes foot arch pain when walking due to pressure through the lump.  To find out more about causes, symptoms and treatment, visit the Plantar Fibromatosis section. 

Common site of stress fractures which cause pain on bottom of foot

Another common cause of foot arch pain is stress fractures.  They tend to occur from repeated overloading of one of the foot bones from activities such as jumping and running especially if you have suddenly increased your activity level.  The breaks in the bone may be small but they can be extremely painful. 

Stress fractures of the metatarsal bones or the navicular can cause anything from mild to severe foot arch pain.  Find out more about the causes, symptoms and treatment options in the Stress Fracture section.

3)  Posterior Tibial Tendonitis

The Tibialis Posterior muscle plays a very important role in supporting the medial arch of the foot and any problems with the muscle can lead to foot arch pain. 

Location of Tibialis Posterior

Posterior Tibial Tendonitis, where there is inflammation of the tibialis posterior tendon, can occur either through repetitive use e.g. high impact sports such as soccer or tennis, or from an injury e.g. a fall.  This causes the tendon to become inflamed or even torn, resulting in pain on the bottom of the foot. 

The pain usually gets worse with activity or when standing for long periods.  If the problem persists, the inner side of the foot (known as the medial longitudinal arch of the foot) gradually collapses down, causing flat feet and further foot arch pain. 

A simple test for this condition is to stand on one leg and rise up onto your tiptoes.  If you cannot rise up, it indicates a problem with the Posterior Tibial tendon.  Treatment usually consists of rest, iceexercises, orthotics and physical therapy.

4)    Tarsal Tunnel Syndrome

Tarsal Tunnel Syndrome develops when there is compression on the tibial nerve as it passes through the tarsal tunnel on the inner side of the ankle bone (medial malleolus).  It can cause pain on the bottom of the foot as well as pins and needles. Numbness in the heel can often extend down to the big toe and adjacent three toes.  In addition, it may also produce hot and cold sensations along the bottom of the foot. 

Tarsal Tunnel Syndrome is caused by anything which occupies space in the tarsal tunnel including cysts, ganglions, bone spurs, swelling from ankle injuries or tumours. 

Treatment aims to reduce the foot arch pain and usually consists of rest, strengthening and stretching exercises, compression bandages and steroid injections.  If the pain in the bottom of the foot persists, surgery may be required.

Trench foot causing numbness and bottom of foot pain

If the feet are exposed to damp conditions for prolonged periods, you can develop Trench Foot.  Most commonly associated with World War One, it now tends to be seen in builders, hikers or festival goers.

With Trench Foot, the sole of the foot turns a white/grey color and you may develop pins and needles or numbness.  Other symptoms include pain in the bottom of the foot and swelling.  If left untreated, you can develop blisters and permanent nerve damage which can lead to the need for amputation.

Treatment and prevention aim to reduce the dampness around the foot and ensure good foot hygiene.  Slowly rewarming the feet and using special products in a foot bath really helps reduce the damage and foot arch pain from Trench Foot.

Find out more, including which famous celebrities have suffered from foot arch pain from this condition in the Trench Foot section.

6)    Foot Cramps

Foot cramps are caused by muscles suddenly spasming uncontrollably.  They most commonly cause foot arch pain but can occur anywhere in the foot and lower leg.  Usually, they only last a few seconds but in more extreme cases they can continue longer. 

Often, there is no obvious reason why people suffer from foot cramps, but possible causes include diet, muscle tightness and weakness, dehydration, reduced circulation and fatigue.  Sometimes, it can be a sign of an underlying medical condition so if the problem keeps recurring, do consult your doctor. 

Some of the best ways to reduce the incidence of foot arch pain from cramps include doing exercises, using heat, drinking plenty of water, using toe stretchers and ensuring you are wearing good footwear.

Find out more about the causes, symptoms and treatment options in the Foot Cramps section.

Athletes foot causing pain on bottom of foot

Athlete’s foot is caused by a fungal infection usually brought on by poor foot hygiene or if the foot is exposed to prolonged damp conditions. 

It can occur in any part of the foot causing dry, flaky and itchy skin. and often results in pain on the bottom of the foot.

Athlete’s Foot can usually be cured by going bare foot for a few days and ensuring good hygiene.  Sometimes, anti-fungal medication will also be prescribed by your doctor.  You can find out more about the causes, symptoms and treatment options for athletes food in the foot rash section.

8)  Flat Feet

Also known as pes planus, this is when the arch of the foot collapses completely dropping the whole sole of the foot down to the ground. 

Flat feet are a common cause of foot arch pain

Babies are born with flat feet and as they grow, the foot arches should gradually form, but in approximately 30% of the population, they never do.  Flat feet can also develop later in life due to illness, pregnancy, injury, excessive stress on the feet or as part of the aging process.

Many people who have flat feet don’t complain of any accompanying symptoms, but some develop foot arch pain, or problems further up the leg such as knee pain or back pain.  They may find their feet tire quickly when they are standing or walking, and that it is difficult to rise up onto their tiptoes. Someone who is experiencing pain on the bottom of the foot or elsewhere due to their flat feet can benefit from exercises and orthotics (specially designed insoles to correct the foot position) as well as walking barefoot rather than in shoes.

A quick test to see if you have flat feet is to put your foot in a tray of water and then place it on a smooth level surface e.g. thick paper.  Have a look at your footprint – the more of the sole of the foot that you can see, the flatter your foot.

9)    Medical Conditions

There are a number of other medical conditions that can cause foot arch pain such as diabetes, arthritis and obesity.  These can affect the position and strength of the bones, muscles, ligaments and tendons, leading to bottom of foot pain. 

10)    Ill-Fitting Shoes

It sounds simple but footwear plays an important role in how our feet feel.  Foot arch pain is commonly caused by ill-fitting shoes, especially ones with little arch support or that are too tight. 

Footwear is particularly important if you are going to be spending long periods on your feet or for sporting activities such as running.  Shoes should be supportive, comfortable, cushioned, provide the appropriate level of arch support and be the correct width. 

What Are The Arches of The Foot?

Arches of the foot

There are twenty six bones in the foot.  The tarsal and metatarsal bones fit together in the middle of the foot and a supported by various ligaments, muscles and tendons to form the foot arches. 

There are two main arches in the foot, the longitudinal arch (indicated in pink on the diagram) which runs down the length of the foot , and the transverse arch (indicated in green) which runs across the width of the foot.

The longitudinal arch can be split into two, the medial longitudinal arch, the higher of the two found in the inner side of the foot, and the lateral longitudinal arch found on the outer side of the foot.

Anything which affects the position of the arches can lead to foot arch pain.

What Else Can Help

You can find out more about these common causes of foot arch pain by clicking on the relevant links above.  Alternatively, if none of these is sounding quite like your problem, visit the foot pain diagnosis section for help working out what is wrong.

Go to Diagnosis Overview or Foot Pain Guide

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