When Is Foot Arch Pain Not Plantar Fasciitis?

What Can Cause Foot Arch Pain That's Not Plantar Fasciitis?

Foot arch pain can be caused by a variety of problems. Most people assume that if you have pain on the bottom of your foot, that it's caused by plantar fasciitis.

The most common symptoms of plantar fasciitis are pain in the heel or arch of your foot when first stepping out of bed, or pain after standing or walking for long periods.

Common Causes Of Foot Arch Pain

• Plantar fasciitis
• Calf muscle trigger points
• Lisfranc Injury
• Nerve Pain
  • Tarsal tunnel syndrome
    • Medial Plantar Nerve
    • 1st Branch of Lateral Plantar Nerve Pain (Baxter' Nerve)
  • L4-S2 Nerve Root Referral
  • Diabetic Neuropathy

Foot Arch Pain From Plantar Fasciitis

The plantar fascia is a thick sheet of tendon-like connective tissue on the bottom of the foot. It's also referred to as the "plantar aponeurosis" as labeled in the image below.

When you have either a high arch foot that's too stiff, or your foot overpronates, you can irritate the plantar fascia, causing it to get inflamed (-itis ="inflammation")

However, in many people with "plantar fasciitis" MRI's of people with foot pain, inflammation is actually NOT present."

Foot Arch Pain From Calf Muscle Trigger Points

Trigger points in your calf muscles can cause referred foot arch pain that's not plantar fasciitis.

Along with stretching your calves, manual trigger point therapy, and trigger point dry needling can help foot arch pain caused by calf muscle trigger points.

Lisfranc Injury

A Lisfranc injury is a sprain or fracture of the midfoot bones that can cause foot arch pain.

Lisfranc injuries usually occur from a traumatic injury to the foot such as landing on a pointed toe.

Lisfranc injuries can cause the arch of the foot to collapse, leading to foot arch pain.  However, often Lisfranc fractures don't show on initial x-rays, especially if the x-rays are not taken in a weightbearing position.  These types of foot injuries often go misdiagnosed for a year or more.

Foot Arch Pain From Nerve Problems

Nerve problems are a highly under-recognized cause of foot pain.

Often nerve pain in the foot gets diagnosed as plantar fasciitis, especially if there's not numbness and tingling in the feet.

Nerves themselves have no "nociceptors" - free nerve endings sensitive to painful stimuli. However, the connective tissue sheaths around nerve DO have nociceptors and can be a source of pain.

Tarsal Tunnel Syndrome

Tarsal tunnel syndrome comes from irritation of the tibial nerve along the inside of the ankle.

The tibial nerve branches into the medial plantar nerve, lateral plantar nerve, and the medial calcaneal nerve.

The medial plantar nerve and the first branch of the lateral plantar nerve can cause foot arch pain that's often mistaken for plantar fasciitis.

Lower Back Nerve Roots (L4-S2)

The nerve roots from the lower back can cause referred pain into the feet.  Foot arch pain can be causes by any of the nerve roots from L4-S2.

Attribution: Modified from Grant, John Charles Boileau, Public domain, via Wikimedia Commons

Often this type of foot pain occurs along with back pain and/or sciatica, but many times people don't connect their foot pain with their back pain or sciatica.

They think "I have back pain and plantar fasciitis" rather than realizing that the foot pain can be caused in whole or in part by their lower back nerves.

Foot Pain From Diabetic Neuropathy

Diabetic neuropathy often occurs in BOTH feet, not just one.  It usually causes some numbness or tingling, along with a burning pain in the feet.

The best treatment for diabetic foot pain is controlling blood sugar through proper diet and exercise.  Diabetic shoes can also reduce the risk of foot ulcers.