Foot Hurts In The Arch When I Walk

Overview

You arch is the curved, raised area made up of your tarsal and metatarsal bones. It helps distribute some of your body weight off of your heel. It is shaped slightly different for everyone-some have lower or ?flatter? arches than others. This doesn?t always cause pain, but when it does, it can make walking and standing unpleasant and difficult. Generally the muscles and other tissues along the arch and even in the heel ache. The inside of the foot and ankle can also swell uncomfortably. Sometimes arches ?fall? inward from an injury or weakness, flattening out an otherwise normal foot.

Pain In Arch

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

Symptoms of plantar fasciitis may occur anywhere along the arch, but it is most common near its attachment to the heel bone. Symptoms of plantar fasciitis vary, but the classic symptom is pain after rest--when you first get out of bed in the morning, or when you get up after sitting down for a while during the day. This is known as "post-static dyskinesia." The pain usually diminishes after a few minutes of walking, sometimes even disappearing, but the pain is commonly felt again the longer you're on the foot. Fasciitis can be aggravated by shoes that lack appropriate support, especially in the arch area, and by the chronic irritation of long-periods of standing, especially on concrete, and by being overweight. Other factors which influence this condition are gender (females get this more than men), age (30s to 50s are most common), and those with flatter-than-normal feet. It doesn't help that fascia doesn't heal particularly quickly. This is because it has relatively poor circulation, which is why it's white in colour.

Diagnosis

The doctor will take a brief history to determine how the injury occurred. If necessary, a thorough physical exam may be conducted to evaluate for any other injuries. Taking your workout shoes to the exam may also provide valuable information to the medical practitioner. Both feet will be physically and visually examined by the medical practitioner. The foot and arch will be touched and manipulated possibly with a lot of pressure and inspected to identify obvious deformities, tender spots, or any differences in the bones of the foot and arch.

Non Surgical Treatment

Cortisone, a type of steroid, is a powerful anti-inflammatory medication. It can be injected into the plantar fascia to reduce inflammation and pain. Your doctor may limit your injections. Multiple steroid injections can cause the plantar fascia to rupture (tear), which can lead to a flat foot and chronic pain. Supportive shoes and orthotics. Shoes with thick soles and extra cushioning can reduce pain with standing and walking. As you step and your heel strikes the ground, a significant amount of tension is placed on the fascia, which causes microtrauma (tiny tears in the tissue). A cushioned shoe or insert reduces this tension and the microtrauma that occurs with every step. Soft silicone heel pads are inexpensive and work by elevating and cushioning your heel. Pre-made or custom orthotics (shoe inserts) are also helpful. Most people sleep with their feet pointed down. This relaxes the plantar fascia and is one of the reasons for morning heel pain. A night splint stretches the plantar fascia while you sleep. Although it can be difficult to sleep with, a night splint is very effective and does not have to be used once the pain is gone. Your doctor may suggest that you work with a physical therapist on an exercise program that focuses on stretching your calf muscles and plantar fascia. In addition to exercises like the ones mentioned above, a physical therapy program may involve specialized ice treatments, massage, and medication to decrease inflammation around the plantar fascia. Extracorporeal shockwave therapy (ESWT). During this procedure, high-energy shockwave impulses stimulate the healing process in damaged plantar fascia tissue. ESWT has not shown consistent results and, therefore, is not commonly performed. ESWT is noninvasive-it does not require a surgical incision. Because of the minimal risk involved, ESWT is sometimes tried before surgery is considered.

Arch Pain

Surgical Treatment

If you have pain that has not been responsive to other treatments, there is a new non-surgical treatment that was recently approved by the FDA. ESWT (extracorporeal shockwave therapy) uses strong electrohydraulic acoustic (sound) energy that triggers the body?s natural repair mechanism. This treatment method is safe, effective and requires a very short recovery period compared to older surgical techniques.

Prevention

The best way to prevent plantar fasciitis is to wear shoes that are well made and fit your feet. This is especially important when you exercise, walk a lot, or stand for a long time on hard surfaces. Get new athletic shoes before your old shoes stop supporting and cushioning your feet. You should also avoid repeated jarring to the heel. Maintain a healthy weight. Stretch when you feel a tightening of the ligament that runs along the bottom of your foot. Stop impact sports when symptoms first occur.

Stretching Exercises

Plantar Fasciitis stretches can be incorporated into a comprehensive treatment regime which may involve: ice, heel wedge support, taping, massage, muscle strengthening, orthotic inserts for shoes, topical anti inflammatory gel or oral medication and/or corticosteroid injections. If you suspect you may have Plantar Fasciitis seek accurate diagnosis and treatment from a health professional to ensure a correct diagnosis and reduce the likelihood of developing chronic foot pain. Treatment interventions may be provided by your Physical Therapist, Podiatrist and/or doctor.

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