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Top-of-the-foot pain typically results from inflammation or injury. It can also occur due to nerve damage. Treatment can depend on the cause and may include rest and medication.
Our feet are made up of not only bones and muscles, but ligaments and tendons, too. These parts carry our entire body weight all day long, so it’s not much of a surprise that foot pain is relatively common.
Sometimes, we’ll feel pain at the top of our foot that can be uncomfortable when walking and even standing still. This pain can be mild or severe, depending on the cause and the extent of any possible injury.
Pain on the top of the foot can be caused by different conditions, the most common of which are due to overuse in activities like running, jumping, or kicking.
Conditions caused by overuse include:
- Extensor tendonitis: This is caused by overuse or tight-fitting shoes. The tendons that run along the top of the foot and pull the foot upwards become inflamed and painful.
- Sinus tarsi syndrome: This is rare and characterized as an inflamed sinus tarsi, or the channel found between the heel and the bone of the ankle. This condition causes pain in the top of the foot and outside the ankle.
- Stress fractures of bones in the feet: Pain can result particularly from fractures in the metatarsal bones, which are located in the top of the feet. This injury will likely have swelling as a symptom.
Other causes of pain on the top of the foot can include:
- gout, which can cause sudden, intense pain in the joint at the base of the big toe
- bone spurs, which are painful growths that form along your joints, in the joints in your feet by your toes
- peripheral neuropathy, which causes pain, prickling, or numbness that can spread up from the feet into the legs
- common peroneal nerve dysfunction, which is the dysfunction of a branch of the sciatic nerve that can cause tingling and pain at the top of the foot, along with weakness of the foot or lower leg
If you have persistent foot pain that lasts longer than a week despite home treatment, you should make an appointment to see your doctor. You should also call your doctor if your pain is severe enough to keep you from walking, or if you have burning pain, numbness, or tingling on the affected foot. You can call your general practitioner, who may refer you to a podiatrist.
When you make an appointment with your doctor, they’ll ask you about any other symptoms and potential ways your foot could have been injured. They may ask about your physical activity and any past injuries to your feet or ankle.
Your doctor will then examine your foot. They may press on different areas on the foot to see where you feel pain. They may also ask you to walk and perform exercises like rolling your foot to evaluate your range of motion.
To test for extensor tendonitis, your doctor will ask you to flex your foot downwards, and then try to pull your toes up while you resist. If you feel pain, extensor tendonitis is likely the cause.
If your doctor suspects a broken bone, fracture, or bone spurs, they’ll order an X-ray of the foot.
Other tests your doctor may run include:
- blood tests, which can identify conditions such as gout
- an MRI to look for damage of the peroneal nerve
Because our feet support our entire body weight, a mild injury could become a more extensive one if it goes untreated. Seeking prompt treatment if you suspect an injury is important.
Treatment depends on the underlying cause of the condition and may include:
- physical therapy, which can help treat conditions such as peripheral neuropathy, extensor tendonitis, and damage to the peroneal nerve
- a cast or walking boot for injuries such as broken bones or fractures
- NSAIDs or other anti-inflammatory drugs, which can help reduce inflammation, including inflammation from gout
- home treatment
Home treatment can help with foot pain in many cases. You should rest and stay off the affected foot as much as possible. You can apply ice to the affected area for twenty minutes at a time, but no more. When you do have to walk, wear supportive, well-fitting shoes that aren’t too tight.
Most causes of pain on the top of the foot are highly treatable, but they need to be treated before the pain and injury get worse. If you have pain in the top of the foot, try to stay off your feet as much as possible for at least five days and apply ice to the affected area for no more than 20 minutes at a time. If home treatments don’t seem to help after five days, make an appointment with your doctor.