Arch Pain
Reviewed by Andrew Schox, BSc(Hons) PGradDipPod MPod, October 2026
Arch pain is pain along the inner curve of your foot. It is a symptom, not one condition, so finding the cause matters. There is no firm figure for how many people have arch pain itself, but foot pain affects at least 1 in 4 older people, and about 1 in 10 adults aged 50 and over have heel pain that can spread into the arch. The commonest causes are plantar fasciitis (irritation of a thick band of tissue under your foot), a flattening arch from a weakened tendon, and wear in the joints in the middle of the foot. The outlook for most adults is generally good, and many improve with simple steps.
What is it?
Arch pain is pain along the inner curve of your foot, between your heel and the ball of your foot. It isn't a single condition. It is a symptom that can come from several different problems, and heel pain, arch pain and midfoot pain often overlap.
Where it hurts, when it is worst and how long you've had it all help your podiatrist work out which problem is behind it.
What can cause it?
Plantar fasciitis is one of the most common causes. The plantar fascia is a thick band of tissue that runs along the sole of your foot and supports your arch. When it is irritated, you usually get pain at the inner side of your heel that can spread forward into the arch. It accounts for 80 per cent of cases of heel pain. It tends to creep on slowly, with sharp pain on your first steps after getting out of bed or after sitting for a while. You may also hear it called plantar fasciopathy.
Adult acquired flatfoot is the main alternative. A tendon on the inside of your ankle (the posterior tibial tendon) helps support your arch. When it stops working well, the arch slowly flattens. You may notice pain and swelling along the inside of your ankle, a foot that looks flatter, trouble rising onto your tiptoes, and later pain on the outside of the ankle. It tends to get worse over time.
Midfoot osteoarthritis is wear in the joints in the middle of your foot. It is the most common reason people with midfoot problems seek help, and many of them have daily pain.
Who gets it?
Related problems are common. Foot pain affects at least 1 in 4 older people. About 1 in 10 adults aged 50 and over have heel pain from the plantar fascia, and 7.9 per cent find it disabling. Midfoot pain affects about 20 per cent of people over 50, and about 12 per cent have midfoot osteoarthritis. Midfoot pain is more common in women and in people with manual jobs. These numbers are for related conditions in older adults, so they are only a guide to arch pain itself.
Some things may raise the chance of plantar fascia pain:
- long periods of standing, walking or running
- a higher body weight
- weak calf muscles
- less movement at the ankle
- one leg slightly longer than the other
- flat feet
Extra body weight can also strain the tendon that supports your arch.
How is the cause found?
Your podiatrist will start by listening. They will ask where the pain is, when it is worst (for example, the first steps after rest) and whether it builds up with standing or walking. They will also ask about any injury, and check for signs of something more serious. Most people who are checked don't have a serious cause.
They will then examine your foot. This usually means pressing along your heel and arch to find the sore spot, checking how far your ankle bends with your knee straight, checking your calf, and seeing whether pain comes on when your big toe is bent upwards. They may also look at the shape of your foot and how you walk.
Scans aren't usually needed, because the cause can usually be worked out from your story and an examination. An ultrasound or MRI scan can help if the cause is still unclear.
Treatment
Most first-line care is simple and you can start it yourself. The aim is to ease the load on your arch while it settles.
Looking after it at home
Adjust what you do rather than stopping completely. Cut back or change the activities that bring on the pain, keep your foot and ankle gently moving, and build walking and exercise back up bit by bit.
Wear comfortable, well-fitted shoes with good arch support and a cushioned heel, especially if you are on your feet for long periods. Heel pads and ice packs can also help ease the soreness.
Gentle calf and arch stretches and simple strengthening exercises can help too. Check first with a health professional if you have a health problem or an injury, and stop if the pain gets worse.
For adults with pain from the plantar fascia, simple advice about staying active, easing the activities that aggravate the pain, and wearing a heel cup (a cup-shaped insert for your heel) led to meaningful improvement over 12 weeks. Many people may not need more than this to start with.
Treatment from your podiatrist
Your podiatrist can work out the likely cause, check your shoes, and set up a stretching and strengthening plan that suits you. They can also talk to you about insoles (shoe inserts).
Insoles are a reasonable low-risk option, especially for very high or very low arches. But expect modest or uncertain benefit. In heel pain they worked no better than dummy insoles, and in adults with flat feet a benefit hasn't been confirmed.
Other options
If your pain isn't settling, your podiatrist may recheck the cause and may refer you to a specialist to talk about options such as an injection, shockwave therapy (pulses of sound waves aimed at the sore area) or surgery.
Adding exercise or a steroid injection to advice and a heel cup gave no extra benefit after 12 weeks. A steroid injection gives only short-term relief and can have side effects, including a torn tendon. It is only considered after other care has been tried, ideally guided by ultrasound. It isn't clear yet how well it works for children and teenagers, people with diabetes, people with inflammatory arthritis such as rheumatoid arthritis, or people who have had heel surgery.
Shockwave therapy needs a specialist assessment first. It isn't yet known which of these options works best.
Will it get better?
For the common causes in adults, the outlook is generally good. With simple care such as advice, staying active and a heel cup, adults with plantar fascia pain improved meaningfully over 12 weeks. How long it takes can differ from person to person and from cause to cause.
Higher body weight is linked to a worse outlook, especially with flat feet. A flattening arch from a weakened tendon is best treated as early as possible, because it tends to get worse over time.
If your pain isn't improving with self-care, is getting worse or keeps coming back, have it looked at rather than waiting.
Preventing it
It isn't yet clear whether particular shoes, insoles or activity changes stop arch pain coming back, so these tips are general advice.
Build up exercise and weight-bearing activity gradually. Getting fitter and stronger can help reduce foot and ankle pain. Ease off mileage or hills if your arch is sore, and pace higher-load activities such as long walks or running.
Keep your foot and ankle moving, and wear comfortable, supportive shoes. If your body weight is a factor, ask a health professional about support to manage it.
When to see a podiatrist
Book an appointment if
Your arch pain isn't improving with self-care, is getting worse or keeps coming back, or it is stopping you from doing your usual activities. Also book if your arch seems to be flattening or you have new swelling along the inside of your ankle, because this can get worse over time. See your podiatrist or GP soon if the shape of your foot is changing, if you notice changes in how you walk such as balance problems or leg weakness, if you have pain at night that doesn't settle, or if you have diabetes or nerve problems (tingling or numbness) and foot pain.
Seek prompt assessment if
- Call your local emergency number if you have an infection and also feel very unwell, with confusion or slurred speech, blue, grey or pale skin, a rash that doesn't fade when you roll a glass over it, or difficulty breathing. This could be sepsis.
- Call your local emergency number if you suddenly become short of breath, have chest pain, or cough up blood.
- Go to the nearest emergency department if your foot or ankle looks out of shape or is at an odd angle after a fall or injury. A fracture can look like a sprain.
- See your GP or another doctor today if you have sudden, severe pain in one joint with swelling, skin colour change, and you feel unwell or feverish. A joint infection can look like this.
- See your GP or another doctor today if your calf is swollen, red, hot and painful, even if your feet also look deep red or purple. A blood clot is one possible cause.
- See your GP or another doctor today if, after a fall or injury, you can't put weight on your foot or the bone is very tender. Do the same if a joint becomes hot and swollen for no clear reason, or if you feel a hit at the back of your ankle, hear a loud pop, or can't point your toes down.
- See your GP or another doctor today if your foot is red, hot and swollen and its shape suddenly changes, especially if you have diabetes or nerve problems. Delay can lead to serious deformity.
- See your GP or another doctor today if you have new foot or ankle pain that has no clear cause and you have had cancer, HIV, TB or inflammatory arthritis. Do the same if the pain comes with fever or weight loss, or if both feet are painful with marked stiffness in the morning.
- If your GP can't see you today, go to an urgent care clinic or an after-hours GP.
- See your GP soon if your pain steadily increases or wakes you at night and doesn't settle.
Frequently asked questions
Is a heel spur causing my arch pain?
Probably not. Heel spurs (small bony growths on the heel bone) are often seen in people with plantar fascia pain, but they aren't considered the cause of the pain. Treatment focuses on easing the strain on the tissue under your foot rather than on the spur.
Are flat feet in a child a problem?
Usually not. A flat foot is normal in children up to about eight years old, and the flatness fades over the first decade of life. In children aged six and younger, a flexible flat foot is nearly always normal. Only a minority (4 per cent of ten-year-olds) have a flat foot that lasts or gets worse. A podiatrist or doctor can check, especially if the foot is stiff or painful.
Is arch pain serious?
Foot and ankle pain is rarely serious, and most people who are checked don't have a serious cause. Still, some signs need prompt attention, such as pain after an injury, fever, or a hot, swollen calf. Check the warning signs on this page if any of them fit.