From the Research
Orthotics are a recommended treatment for pain over the transverse arch of the foot, as they provide direct support and redistribute pressure away from painful areas. The most effective type of orthotic for this condition is a custom or over-the-counter metatarsal pad or arch support, which should be worn in supportive shoes with adequate width in the toe box 1. A metatarsal pad should be positioned just behind the painful area, not directly under it. To allow the foot to adjust, start by wearing the orthotics for 1-2 hours daily, gradually increasing to full-day use over 1-2 weeks.
Complementary treatments include:
- Rest
- Ice for 15-20 minutes several times daily
- Over-the-counter anti-inflammatories like ibuprofen (400-800mg three times daily with food) or naproxen (220-440mg twice daily with food) for pain relief
- Gentle foot stretches
Orthotics work by supporting the natural arch structure, preventing excessive flattening during weight-bearing activities, and reducing stress on ligaments and joints in the midfoot. This mechanical support helps alleviate pain by correcting biomechanical imbalances that contribute to transverse arch collapse and associated discomfort. According to a study published in the Journal of the American Podiatric Medical Association, custom foot orthoses were effective in reducing foot pain and improving function in people with a cavus foot type 1.
It's essential to note that while orthotics can be effective, they should be used in conjunction with other treatments and under the guidance of a healthcare professional. The most recent and highest quality study on this topic, published in 2015, found that orthotics, both prefabricated and custom fitted, reduce pain and improve function in adults with acute plantar fasciitis 2. However, the study with the most direct relevance to the transverse arch, published in 2006, provides the strongest evidence for the use of custom foot orthoses in treating cavus foot pain 1.