Does Pain In The Arch Need Surgical Treatment ?
OverviewYou 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.CausesThe more common specific causes of arch pain (arch strain) tend to be Plantar fasciitis (strain of the plantar fascia - a strong ligament that supports the arch. Foot strain from a pronated / flat foot or high arched foot. Osteoarthritis of the joints in the mid-foot. Poor or improper footwear (high heels or athletic shotes). Tarsal tunnel syndrome (a pinched nerve at the ankle that refers to pain in the arch). There are two arches in each foot. The longitudinal arch runs the length of your foot, and the transverse arch runs across the width of your foot. The arches are made up of ligaments, which keep the bones of your foot in place. Arch pain can occur in one or both arches, but occurs most commonly in the longitudinal arch. If this arch pain (arch strain) condition is left untreated and strain on the longitudinal arch continues, a bony protrusion may develop, known as a heel spur. It is important to treat the condition and seek a proper consultation.SymptomsFlat feet don't usually cause problems, but they can put a strain on your muscles and ligaments (ligaments link two bones together at a joint). This may cause pain in your legs when you walk. If you have flat feet, you may experience pain in any of the following areas, the inside of your ankle, the arch of your foot, the outer side of your foot, the calf, the knee, hip or back, Some people with flat feet find that their weight is distributed unevenly, particularly if their foot rolls inwards too much (overpronates). If your foot overpronates, your shoes are likely to wear out quickly. Overpronation can also damage your ankle joint and Achilles tendon (the large tendon at the back of your ankle). See your GP if you or your child has flat feet and your feet are painful, even when wearing supportive, well-fitting shoes, shoes wear out very quickly, feet appear to be getting flatter, feet are weak, numb or stiff, Your GP may refer you to a podiatrist (foot specialist).DiagnosisIn a person of any age, the doctor will ask about occupational and recreational activities, previous foot trauma or foot surgery and the type of shoes worn. The doctor will examine your shoes to check for signs of excessive wear. Worn shoes often provide valuable clues to gait problems and poor bone alignment. The doctor will ask you to walk barefoot to evaluate the arches of the feet, to check for out-toeing and to look for other signs of poor foot mechanics.Non Surgical TreatmentStretch the fascia. Prop your toes up against a wall, keeping your arch and heel flat so the toes stretch. Hold for a count of 10. Repeat 10 times three or four times per day. Roll a frozen water bottle under the arch. Stretch first then roll out the arch for 10 minutes; you don?t want to stretch the tendon when it?s ice cold. Freeze a golf ball and massage the fascia. Roll the frozen golf ball under the foot, starting from the front and working your way back. Put good pressure on each spot-the medial, center and lateral positions-for 15 seconds before moving to the next area. Then, roll the ball back and forth over the entire foot. Foam roll all muscles on the body above the plantar. Even tight shoulders can cause the condition, as your arm swing can throw off proper hip alignment and footstrike. Bump your arch. Get a commercial insole with an arch bump to push on the plantar and keep it from flexing-it doesn?t matter if you?re an under or overpronator; the plantar needs to be supported and strengthened, Wear the support in all shoes, if possible.Surgical TreatmentThe main goal of surgery is to reduce pain and improve function. It may also reduce other injuries such as repeated ankle sprains and broken bones. Surgery may be considered if there is no relief with physical therapy, changes in shoewear and/or changes in activity. Some patients will also have tendon problems, ankle weakness and foot fractures. These patients may require other procedures to address related problems. If you have medical problems that make surgery unsafe, any infections or blood vessel disease, cavus foot surgery may not be appropriate. The surgical procedures involved with the correction of the cavus foot are varied. Theses may include correction of the bony deformity, ankle looseness and the muscle imbalances that cause the deformity. The goal is to provide a foot that evenly distributes weight along both inside and outside edges. A variety of incisions may be needed to perform the procedures related to the correction of the cavus foot.Stretching ExercisesInchworm. 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.