Arch Pain

Tarsal tunnel syndrome results from compression of a nerve that runs through a narrow passage behind the inner ankle bone down to the heel. It can cause pain anywhere along the bottom of the foot. It is often associated with diabetes, back pain, or arthritis. It may also be caused by injury to the ankle or by a growth, abnormal blood vessels, or scar tissue that press against the nerve. Magnetic resonance (MR) imaging and the dorsiflexion-eversion test are being used to diagnose this syndrome.

Treatment for Tarsal Tunnel Syndrome. Pain from tarsal tunnel syndrome may be relieved by treatment with orthotics, specially designed shoe inserts, to help redistribute weight and take pressure off the nerve. Corticosteroid injections may also help. Surgery is sometimes performed, particularly if symptoms persist for more than a year, although its benefits are under some debate. Tarsal tunnel syndrome caused by known conditions, such as tumors or cysts, may respond better to surgery than when the cause is not known. Recovery from this surgery can take months before a person can resume normal activity. It should be performed by only experienced surgeons.

text continues below

Flat Foot

Flat foot, or pes planus, is a defect of the foot that eliminates the arch. The condition is most often inherited. Arches, however, can also fall in adulthood, in which case the condition is sometimes referred to as posterior tibial tendon dysfunction (PTTD). This occurs most often in women over 50, but it can occur in anyone. The following are risk factors for PTTD:

Wearing high heels for long periods of time is a particular risk for flat feet. In such cases, over the years, the Achilles tendon in the back of the calf shortens and tightens, so the ankle does not bend properly. The tendons and ligaments running through the arch then try to compensate. Sometimes they break down, and the arch falls.
Some studies have indicated that the earlier one starts wearing shoes, particularly for long periods of the day, the higher the risk for flat feet later on.
Other conditions that can lead to PTTD include obesity, diabetes, surgery, injury, rheumatoid arthritis, or use of corticosteroids.