Why does the bottom of my arch hurt

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Foot arch pain is a common problem, largely due to the amount of pressure going through our feet, especially if you are on your feet a lot.

This is because the muscles and tendons that support the foot arches have to work hard to stabilise the foot and can quickly fatigue resulting in pain on the bottom of the foot.

Weakness and tightness in the foot muscles changes how the forces go through the feet and up the legs so foot arch pain is often associated with back and knee pain too. There may also be lumps and bumps underneath the foot.

Common Causes of Foot Arch Pain

So let's look at the most common causes of pain in the foot arches, and how they present, then we'll find out more about how to treat them.

1. Plantar Fasciitis

The most common cause of foot arch pain by far is plantar fasciitis. This is where there is damage to the thick band under the foot.

Plantar fasciitis usually develops due to altered foot biomechanics, bone spurs and muscle tightness and often affects people who spend long periods on feet or suddenly increase their activity levels.

Typical symptoms of plantar fasciitis are foot arch pain near the heel that is worse in the morning and with initial movement. The pain under the foot arch usually improves as you get going but will get worse again with too much activity.

You can find out all about the common causes, symptoms and treatment options of this common cause of foot arch pain in the Plantar Fasciitis section.

2. Foot Cramps

Another common cause of foot arch pain is cramp. Foot cramps affects around 25% of people over the age of 60, particularly at night.

Foot cramps are sudden, uncontrollable, intense muscle spasms lasting anywhere from a few seconds to several hours. They result in sharp, intense calf, toe or foot arch pain, muscle spasm and even toe curling.

Cramps in the foot arch may be caused by dehydration, lack of vitamins & minerals, muscle tightness, fatigue, nerve damage or poor circulation

You can find out all about the common causes, symptoms and treatment options as well as how to prevent foot arch pain from cramp in the Foot Cramps section.

3. Tarsal Tunnel Syndrome

Tarsal tunnel syndrome is one of the less common causes of foot arch pain caused by pressure on the tibial nerve as it passes through the tarsal tunnel 

Anything abnormal that takes up space in the tarsal tunnel e.g. bone spurs, swelling, cysts will compress the nerve and cause pain underneath the foot arch.

Typical symptoms of tarsal tunnel syndrome include inner arch foot pain, pins & needles and numbness.

Find out all about the causes, symptoms and treatment options in the Tarsal Tunnel Syndrome section.

4. Plantar Fibromatosis

Another possible cause of pain under the foot arch is plantar fibromatosis, a condition where small nodules develop in the plantar fascia, usually in the middle of the foot arch.

Plantar fibromatosis may develop due to a foot injury, genetics or various medical conditions.

Typical symptoms of plantar fibromatosis include a small, firm lump underneath the foot, toe curling and foot arch pain with any pressure over the nodules. Plantar fibromas are one of the most common causes of lumps on the bottom of the foot.

Find out all about the common causes, symptoms and treatment options in the Plantar Fibromatosis section.

5. Posterior Tibial Tendonitis

Inner arch foot pain is often due to inflammation and degeneration of the tibialis posterior tendon. Tibialis posterior is an important muscle and its tendon plays a vital role in supporting the foot arches.

Tibialis posterior tendonitis tends to develop from overuse during high impact activities e.g. tennis or soccer, or following an injury e.g. a fall.

Typical symptoms of posterior tibial tendonitis are pain in the foot arch and around the ankle, collapsing of the medial foot arch and an inability to stand on tiptoes.

You can find out this common cause of pain in the foot arch in the Posterior Tibial Tendonitis section.

6. Stress Fractures

Stress fractures, tiny breaks in one or more of the foot bones, can cause sharp pain in the foot arch.

Stress fractures are usually caused by repetitive overloading of the foot bones from high-impact activities e.g. running & jumping and often develop when suddenly increasing training levels.

Stress fractures typically cause localised foot arch pain around the fracture site with associated bruising and swelling, often causing difficulty walking.

Find out all about the common causes, symptoms and treatment options for severe arch pain in the Foot Stress Fractures section.

7. Flat Feet

People with flat foot often develop inner arch foot pain. Flat feet develop when the foot arches collapse causing the sole of the foot to drop down. Around 30% of people have flat feet. 

Some people are born with flat feet but they can also develop during pregnancy, after a foot injury, when there is excessive stress on feet or as we age.

Fallen foot arches may cause fatigue in feet, foot arch pain, back pain and knee pain, cramps in the foot arch and can make it difficult to push up onto your tiptoes which can affect how you walk.

Wearing specially designed orthotics e.g. arch supports can really help to reduce pain in the arches of feet.

8. Trench Foot

Trench foot tends to cause pain on the bottom of both feet. Also known as Immersion Foot, trench foot is caused by tissue & nerve damage due to reduced blood flow to the feet.

Trench foot develops with prolonged exposure to damp conditions, poor foot hygiene and sweaty feet and typically affects hikers, festival-goers & runners.

Common symptoms of trench foot include swollen, white/grey feet, prickly pain under foot, numbness, pins and needles, blistering and possible gangrene if left untreated.

Find out all about the common causes, symptoms and treatment options, including which celebrities have suffered from it, in the Trench Foot section.

The Importance Of Footwear

It sounds simple but footwear plays an important role in how our feet feel.  Foot arch pain is often 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. 

It can also help to go bare foot when you can to reduce the amount of pressure and friction through the feet and thus reduce pain in the foot arch.

What Are The 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 are supported by various ligaments, muscles and tendons to form the foot arches. 

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. 

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:

• Medial Longitudinal Arch: the higher of the two found in the inner side of the foot 
• 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 and discomfort on the bottom of the foot.

Foot Arch Pain Treatment

Treatment for foot arch pain will depend on what is causing the pain on the bottom of the foot. Typical treatment for pain under the foot arch includes:

• Stretches: to reduce the tension in the muscles can really help to reduce cramps and pin in foot arches

• Strengthening Exercises: to improve the strength, stability and endurance of the foot muscles helps to support the foot arches and thus reduce pain

• Ice: Regular use of ice packs, or placing a frozen bottle of water under your foot helps to reduce pain under foot arch and swelling - 10 mins max per application

• Orthotics: Special inserts for your shoes to correct foot position and support painful foot arches

• Toe Stretchers: handy little devices to help stretch out the toes and the bottom of the feet which can really reduce foot pain in arches

• Foot Rollers: Simply roll your feet over these as you relax to ease your foot arch pain

You can find out more about specific treatment for each different cause of pain on the bottom of the foot by reading the full articles for each condition.

What Else Can Help?

If none of these is sound quite like your foot arch pain and you want some help working out what is wrong, visit the foot pain diagnosis section.

Alternatively, if you have other symptoms as well as pain, such as foot swelling, a rash or numbness, in the foot pain symptoms section we'll help you to identify what is going on and what you can do about it. Or if you have any lumps or bumps under your foot, check out the Bump On Bottom Of Foot article.

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