Does Arch Pain Need Surgical Procedures ?

posted on 16 Apr 2015 09:13 by joliehonhart
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.

Arch Pain

Causes

There are several reasons why arch pain develops. Sometimes it?s due to a condition known as plantar fasciitis, in which the plantar fascia (the band of tissue that runs along the bottom of your foot from your heel to your toes) becomes inflamed after excessive stress. Heel pain results from this inflammation. Sometimes the pain is due to extensive time spent on your feet. Many people feel pain on the arch of their feet after a long workday, while others overuse their feet exercising or playing sports. A foot deformity, such as hammertoe or clubfoot, can also cause this pain. Medical conditions such as diabetes or obesity can put additional stress on your feet, thereby causing arch pain. Your footwear is also important. Shoes should support all parts of your foot, especially the bottom. This is very important if you spend excessive time on your feet, if your obese, if your pregnant, or if you engage in sport-related activities. Injuries to any of the twenty-six bones, thirty-three joints and over 100 muscles, tendons and ligaments in the feet can also cause arch pain. Because the foot is such a complex structure, it?s important to see a podiatrist at the first sign of symptoms.

Symptoms

Typically, the sufferer of plantar fasciitis experiences pain upon rising after sleep, particularly the first step out of bed. Such pain is tightly localized at the bony landmark on the anterior medial tubercle of the calcaneus. In some cases, pain may prevent the athlete from walking in a normal heel-toe gait, causing an irregular walk as means of compensation. Less common areas of pain include the forefoot, Achilles tendon, or subtalar joint. After a brief period of walking, the pain usually subsides, but returns again either with vigorous activity or prolonged standing or walking. On the field, an altered gait or abnormal stride pattern, along with pain during running or jumping activities are tell-tale signs of plantar fasciitis and should be given prompt attention. Further indications of the injury include poor dorsiflexion (lifting the forefoot off the ground) due to a shortened gastroc complex, (muscles of the calf). Crouching in a full squat position with the sole of the foot flat on the ground can be used as a test, as pain will preclude it for the athlete suffering from plantar fasciitis, causing an elevation of the heel due to tension in the gastroc complex.

Diagnosis

After you describe your symptoms and discuss your concerns, your doctor will examine your foot. Your doctor will look for these signs. A high arch. An area of maximum tenderness on the bottom of your foot, just in front of your heel bone. Pain that gets worse when you flex your foot and the doctor pushes on the plantar fascia. The pain improves when you point your toes down. Limited "up" motion of your ankle.

Non Surgical Treatment

Rest is the most important thing you can do. Stay off your feet, or use a cane. Gently apply ice to the arch for at least 30 minutes, and repeat every 3 or 4 hours. Apply mild compression to the foot. Use a Fabriform PSC Foot and Ankle Strap to help support the arch, reduce swelling, and relieve pain and fatigue. This strap is easy to apply and adjust for a custom fit. Low profile allows it to fit in any shoe. Allows you to apply just the right amount of arch support/compression for your foot. Before stepping down after sleeping or resting, stretch the arch of your foot by pulling up on the ball of the foot and toes, as far as you comfortably can; hold the foot in this position for ten seconds. Repeat at least ten times. Consideration should also be given to the use of night splints. These are very effective for stretching the plantar fascia to relieve first weight bearing pain.

Arch Pain

Surgical Treatment

Surgery may be necessary in situations where the symptoms are likely to get worse over time, or when pain and instability cannot be corrected with external orthopedic devices. There are many types of surgical procedures, including cavus foot reconstruction, which can be performed to correct the foot and the ankle and restore function and muscle balance.

Prevention

Warm up properly. This means not only stretching prior to a given athletic event, but a gradual rather than sudden increase in volume and intensity over the course of the training season. A frequent cause of plantar fasciitis is a sudden increase of activity without suitable preparation. Avoid activities that cause pain. Running on steep terrain, excessively hard or soft ground, etc can cause unnatural biomechanical strain to the foot, resulting in pain. This is generally a sign of stress leading to injury and should be curtailed or discontinued. Shoes, arch support. Athletic demands placed on the feet, particularly during running events, are extreme. Injury results when supportive structures in the foot have been taxed beyond their recovery capacity. Full support of the feet in well-fitting footwear reduces the likelihood of injury. Rest and rehabilitation. Probably the most important curative therapy for cases of plantar fasciitis is thorough rest. The injured athlete must be prepared to wait out the necessary healing phase, avoiding temptation to return prematurely to athletic activity.

Stretching Exercises

Inchworm. Stand with your weight on one foot. Raise the metatarsal heads of the unweighted foot while you pull its heel closer to your toes. Next, raise your toes toward the ceiling, and then relax your whole foot with it flat on the floor. Your foot should move like an inchworm across the floor. Reps 6-7 for each foot. Horsepawing. Stand with your weight on one foot and the other foot slightly in front of you. Raise the metatarsal heads on the front foot. Lift your heel ever so slightly off the ground, maintaining the raised metatarsal heads, and pull your foot toward you so that it ends up behind you. Return this foot to the starting position in front of you. You should really feel this one in your arch. Reps. 6-7 for each foot. Toe pushups. Sit in a chair with your feet resting on the floor. Raise your heel as high as you can while keeping your toes flat on the floor. This is the starting position. Using your toe muscles, roll your foot upward until the weight of your foot is resting on the ends of your toes, like a dancer standing on point in toe shoes. Roll back down to the starting position. Reps. 10-20 for each foot. Sand scraping. Pretend you are at the beach standing in loose sand. Use your big toe to pull sand inward toward your body, with your little toe off the ground. Then use your little toe to push it away, with your big toe off the ground. Reps. 10 for each foot. Now reverse the exercise: pull the sand inward with your little toe and push it away with your big toe. Reps. 10 for each foot.