Inner Arch Foot Pain And Swelling

Overview
The phrase arch pain (or arch strain) refers to an inflammation and/or burning sensation under the long arch of the foot. This is a common foot condition that can be easily treated. Arch pain (arch strain) has the tendency to occur as a result of overuse in activities / exercises such as running, jumping, tennis, squash, hiking, walking, and skiing / snowboarding. People who have flat feet, or people whose feet flatten and roll inward (called ?over pronation?) are more prone to arch pain. Arch pain usually occurs gradually. However, it can occur suddenly if the fascia ligaments are stretched or torn during a forceful activity such as sprinting or jumping. An accurate diagnosis from a podiatrist (foot doctor) is important early in the management of arch pain.


Causes
Stress fractures, plantar fasciitis, and acute and chronic arthritis are most commonly the result of repetitive micro-trauma injuries. Micro-trauma injuries are caused when the structures of the body are stressed and re-stressed to the point that damage occurs in the tissues. Factors that commonly contribute to this injury can be running on uneven surfaces or surfaces that are too hard or too soft, shoes that have poor force-absorption qualities, or going too hard or too long during repeated exercise bouts.

Symptoms
Intense heel pain, especially first thing in the morning and after a long day. Difficulty walking or standing for long periods without pain. Generally, the sharp pain associated with plantar fasciitis is localized to the heel, but it can spread forward along the arch of the foot and back into the Achilles tendon. While severe cases can result in chronic pain that lasts all day, the most common flare ups occur first thing in the morning, making those first steps out of bed a form of torture, and in the evening after having spent a day on your feet. Overpronation (a foot that naturally turns too far inward), high arches, and flat feet (fallen arches) can all cause similar arch pain. In these cases, however, the pain is more likely to continue throughout the day rather than being worst in the morning.

Diagnosis
Your doctor may order imaging tests to help make sure your heel pain is caused by plantar fasciitis and not another problem. X-rays provide clear images of bones. They are useful in ruling out other causes of heel pain, such as fractures or arthritis. Heel spurs can be seen on an x-ray. Other imaging tests, such as magnetic resonance imaging (MRI) and ultrasound, are not routinely used to diagnose plantar fasciitis. They are rarely ordered. An MRI scan may be used if the heel pain is not relieved by initial treatment methods.

Non Surgical Treatment
There is considerable debate about the best treatment option for plantar fasciitis. Some authors suggest all of the 'mainstream' methods of treatment don't actually help at all and can actually make the symptoms worse! However, on the whole, there are several of the most commonly cited treatment options for plantar fasciitis and these are generally accepted throughout the medical community. I would recommend giving these options a try if you haven't already. Rest. This is mainly applicable to the sports people as rest is possible treatment. (For those who cannot rest e.g. people who work on their feet - skip to the other treatment options below). Rest until it is not painful. This is made more difficult as people need to use their feet to perform daily activities but certainly stop sporting activities that are likely to be putting the fascia under excessive stress. Perform Self Micro-Massage (you can watch this video by clicking the link or scrolling further down the page as it's embedded on this lens!) This massage technique is used to break down fibrous tissue and also to stimulate blood flow to the area, both of which encourage healing and reduce pain. There is also a potentially soothing effect on nerve endings which will contribute to pain relief. Ice Therapy. Particularly useful after spending periods on your feet to reduce the inflammation. Wrap some ice or a bag of frozen peas in a towel and hold against the foot for up to 10 minutes. Repeat until symptoms have resolved. Heat Therapy. Heat therapy can be used (not after activity) to improve blood flow to the area to encourage healing. A heat pack of hot water bottle can be used. 10 minutes is ideal. Careful not to burn yourself! A good taping technique. By taping the foot in a certain way you can limit the movement in the foot and prevent the fascia from over-stretching and gives it a chance to rest and heal. Click on the link for more information on taping techniques. Weight Management. If you are over-weight, any weight you can loose will help to ease the burden on your sore feet and plantar fascia. Orthotic devices (often mis-spelled orthodic) are special insoles that can be used to limit over-pronation (discussed earlier) and control foot function. By preventing the arches flattening excessively, the plantar fascia is not over-stretched to the same extent and this should help with the symptoms and encourage healing. Stretching the calf muscles (again, click this link or scroll to the bottom of the page to watch the embedded video) can help to lengthen these muscles and the Achilles tendon - a risk factor for plantar fasciitis. Stretching of the plantar fascia itself is also encouraged, particularly before getting up the morning (night splints can be used for this effect) and after periods of rest. This can be achieved by placing a towel or band under the ball of the foot and gently pulling upwards until a stretch is felt. Hold for about 15-20 seconds then rest briefly. Repeat 2-3 times. As you can see there are many different treatment options available. Try incorporating some of these in to your daily routine and see what works for you. Regardless of the method the main aim is to prevent the fascia from over-stretching! Medical professionals such as a Podiatrist may decide to make custom orthotics or try ultra-sound therapy. It is likely that anti-inflammatory medications will also be recommended. If you have tried the treatment options and your symptoms persist I'd recommend going to see a medical professional for further advice.


Surgical Treatment
Surgery is considered only after 12 months of aggressive nonsurgical treatment. Gastrocnemius recession. This is a surgical lengthening of the calf (gastrocnemius) muscles. Because tight calf muscles place increased stress on the plantar fascia, this procedure is useful for patients who still have difficulty flexing their feet, despite a year of calf stretches. In gastrocnemius recession, one of the two muscles that make up the calf is lengthened to increase the motion of the ankle. The procedure can be performed with a traditional, open incision or with a smaller incision and an endoscope, an instrument that contains a small camera. Your doctor will discuss the procedure that best meets your needs. Complication rates for gastrocnemius recession are low, but can include nerve damage. Plantar fascia release. If you have a normal range of ankle motion and continued heel pain, your doctor may recommend a partial release procedure. During surgery, the plantar fascia ligament is partially cut to relieve tension in the tissue. If you have a large bone spur, it will be removed, as well. Although the surgery can be performed endoscopically, it is more difficult than with an open incision. In addition, endoscopy has a higher risk of nerve damage. The most common complications of release surgery include incomplete relief of pain and nerve damage. Most patients have good results from surgery. However, because surgery can result in chronic pain and dissatisfaction, it is recommended only after all nonsurgical measures have been exhausted.


Prevention
Strap the arches into the anatomically correct positions with athletic tape and leave them like this for some time. If the fallen arches are an issue with the muscular structure, this may give the muscles an opportunity to strengthen. This is definitely not a fallen arches cure all the time but it can help prevent it more times than not. Ask a doctor or physical therapists to show you how to do this taping. Find shoes that fit. This may require that you get your foot measured and molded to ensure that the shoe will fit. Shoes that are too big, too tight or too short, may not directly cause the fallen arches, but they can assist with the damage to the area. These shoes should have thick cushioning inside and have plenty of room for your toes. Walk without shoes as much as possible. Shoes directly assist with weakening and distorting the arches of the feet so going without shoes can actually help strengthen your arches and prevent fallen arches. Walking on hard and bumpy surfaces barefooted makes the muscles in your feet strengthen in order to prevent injury. It is a coping mechanism by your body. Insert heel cups or insoles into the shoes that you wear the most. Many people wear uncomfortable shoes to work and these are the same shoes that cause their arches the most problems. Inserting the heel cups and insoles into these shoes can prevent fallen arches from occurring. Many people place these inserts into all their shoes to ensure support. Ask a medical professional, either your doctor or a physical therapist, about daily foot exercises that may keep the arches stronger than normal. Many times, you can find exercises and stretches on the Internet on various websites. Curling your toes tightly and rotating your feet will help strengthen your longitudinal arches. Relax your feet and shake them for a minute or so before you do any arch exercises. This will loosen the muscles in your feet that stay tight due to normal daily activities. Wear rigid soled sandals whenever possible to provide a strong support for your arches. Wooden soled sandals are the best ones if available. Walk or jog on concrete as much as you can. This will create a sturdy support for your arches. Running or walking in sandy areas or even on a treadmill, does not give rigid support. Instead, these surfaces absorb the step, offering no support for arches.

Stretching Exercises
Point your toes. To ease foot pain and aching in your feet, lift one foot and roll it downward until the toes are pointed toward the ground. Then flex your foot. Repeat using the other foot. This exercise will help stretch out all the small muscles that are on the bottom of your feet, which can help relieve aching and improve blood circulation. Raise your heels. This exercise is good for relieving toe cramps caused by standing for hours in constricting shoes, says Kurtz. Bonus: It can also strengthen calf muscles and make them look more defined. Stand up and lift your heels so that you are standing on the balls of your feet. Hold for 10 seconds. Repeat 10 times. Squeeze your toes. To strengthen the toes and help alleviate foot pain from hammertoes (when a toe resembles a claw), separate your toes using corks or foam toe separators and then squeeze your toes together for five seconds. Repeat 10 times. Roll a ball. Want to create an instant massage for the bottom of your feet? Roll a golf ball or tennis ball under the ball of your foot. Apply light pressure for about two minutes. This exercise can be helpful for arch pain, cramps, and heel pain from plantar fasciitis. Stretch standing up. A weight-bearing, runners-type stretch can be helpful for foot pain in the arch. Stand up and place your toes against a wall; lean forward a little until you feel your arch stretch. Repeat using the other foot. Stretch sitting down. Sit barefoot and cross your left leg so that your ankle rests on your right thigh. Then hold your toes and bend them back toward your shin, stretching the band of tissue connecting the bottom of the heel to the ball. A University of Rochester study found that people living with plantar fasciitis had a 75 percent chance of having no pain within three to six months of performing this stretch three times daily. Give yourself a foot massage. Nothing spells pain relief like a good foot rub. Use the following technique recommended by Rhonda Crockett, a licensed massage therapist at Ohio State University?s Center for Integrative Medicine in Columbus. Start with your toes, using your thumb to massage them in circular motions. Then move to the arch under your foot and gradually work your way down to the heel, applying pressure with your fingers and palm of your hand. Use lotion to allow your hand to move smoothly over your foot. Relax in a warm bath with Epsom salts. The combination of warm water and Epsom salts will give you a double dose of pain relief and relaxation. Magnesium sulfate, the key compound in Epsom salts, has been found to relax muscles, reduce pain, and sedate the nervous system. Plus, warm water helps improve circulation in the feet and relieve muscle pain. Crockett recommends adding two cups of Epsom salts to a warm bath and soaking for 20 minutes.