Here we explain the causes of pain in the arch of the foot including Plantar fasciitis, Heel spur as well as nerve entrapments such as Tarsal tunnel syndrome.
Plantar fasciitis is probably the most common cause of pain under the heel which radiates into the arch of the foot.
- Symptoms usually develop gradually over time.
- Pain is usually worse first thing in the morning, or after a long period of sitting.
- Foot arch pain improves during the day as your plantar fascia (arch ligament) warms up, only for the pain to return again later in the day as it becomes inflamed again.
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A Heel spur is a bony growth on the heel bone (Calcaneus) at the point where the Plantar fascia attaches.
- Symptoms of a heel spur are the same as Plantar fasciitis, but the two are not the same.
- Plantar fasciitis can occur without the presence of a Heel spur, and a Heel spur can occur without any painful symptoms at all.
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Tarsal Tunnel Syndrome
Tarsal tunnel syndrome is a nerve impingement in the foot. Pressure on a nerve which passes along the inside of the ankle causes the following symptoms:
- A buring type pain which often radiates into the arch of the foot.
- You may feel Pins and needles or tingling. The pain is caused by
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Medial Calcaneal Nerve Entrapment
Medial calcaneal nerve entrapment, often called ‘Baxter’s nerve’ has similar symptoms to that of tarsal tunnel syndrome.
- A burning pain on the inside of the ankle, below the medial malleolus (bony bit on the inside of the ankle).
- Pain radiates under the heel and into the arch of the foot.
Plantar Fascia Strain (Foot Arch Strain)
A Plantar fascia strain is a strain of the plantar fascia which forms the arch of the foot.
- It might result from one single traumatic incident, resulting in sudden pain, or may gradually occur over a period of time through overuse.
- Symptoms include localised tenderness and pain over the plantar fascia.
- You may have a nodule or lump, where the plantar fascia has torn.
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Tibialis posterior tendinopathy
The tibialis posterior tendon passes down the back of the leg, inside the ankle, and under the foot. Symptoms include:
- Pain on the inside of your ankle which may also radiate along the length of the tendon, under the arch of the foot.
- It is more common in older female athletes but has been known to affect younger ballet dancers.
- If there is significant pain under the foot then this may indicate a partial avulsion, where the tendon pulls away from the bone at the attachment to the bone.
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Navicular Stress Fracture
A navicular stress fracture is a hairline fracture of the Navicular bone in the ankle caused by overuse and is one of the most common stress fractures affecting athletes.
- Symptoms include a poorly localized ache in the midfoot, which may radiate along the inside arch of the foot.
- Pain becomes worse with exercise, subsides quickly with rest, only to return again as training resumes.
- Tenderness may be felt when the thumb is pressed into the top of the foot over the navicular bone (called the N spot).
- Stress fractures do not always appear on X-rays until they have started to heal. Then the new bone growth can be seen.
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