Why Does the Top of My Foot Hurt?

Understanding Your Top of Foot Pain

Feeling a sharp pain on the top of the foot is very common. Many of us take hundreds of steps or more a day. This number is increased if you play sports or run.

The pain you are feeling can be due to injury, overuse, everyday wear and tear, or even footwear that does not properly fit. Pain on top of the foot can also result from an issue within your bones, soft tissues, or other health conditions.

What Causes Pain on Top of the Foot?

Now that you know the possible reasons why you may be having top-of-the-foot pain, it is time to explain what can cause it. There are several factors that can cause top-of-the-foot pain.

As mentioned earlier, your bones, soft tissue, and medical conditions can cause pain. While dropping something heavy on your foot is an obvious reason to make your foot hurt, other reasons may need a little investigation. Our foot, ankle, and podiatry experts will discuss some of the causes in detail below.

Stress Fractures

Stress fractures are a common cause of pain. A stress fracture is a small break in one of the bones within your foot, usually resulting from repetitive overuse. This can occur while running, kicking, jumping, increasing training levels, and other impact activities. Stress fractures tend to worsen with activity.

Additional Fractures

• Jones fractures occur when the bone fractures in the middle, outside your foot.
• Avulsion fractures happen when a ligament or tendon pulls a tiny piece of bone out of place.

Sinus Tarsi Syndrome

Sinus tarsi syndrome is a common cause of continuous pain that can be felt at the top of your foot and on the outer side of your ankle. This generally occurs after an ankle sprain but can also result from prolonged instability.

The small, bony channel between the heel and ankle becomes inflamed, resulting in ankle stiffness, instability, and pain when walking or standing.

Extensor Tendonitis

Extensor tendonitis is one of the most common causes of a gradual onset of swelling, tenderness, and pain on top of the foot. Extensor tendonitis occurs in the tendons that flex and pull the foot upward. These tendons become inflamed and contract, which causes your toes to lift.

This can be due to prolonged standing or walking, muscle tightness, off-road running, and simply the genetic makeup of your foot. Wearing shoes, especially shoes that are too tight, can add more pressure on the extensor tendons that are already inflamed, which can cause additional discomfort.

Arthritis

Arthritis pain can begin at the base of your big toe joint and work its way up to the top of the arch of your foot.

Tibialis Anterior Tendonitis

Tibialis anterior tendonitis occurs when the tendon at the front of the ankle becomes inflamed. This pain often feels worse after resting.

Gout

Gout is a type of inflammatory arthritis in which too much uric acid crystallizes and deposits in the joint, specifically your big toe. This pain is intense and can be felt from your big toe to the top of your affected foot. This intense pain usually occurs at night and is accompanied by redness and swelling.

Peripheral Neuropathy

Nerve pain on the top of the pain can be caused by peripheral neuropathy. It is accompanied by a lack of sensation, numbness, or foot weakness and is often due to a pinched nerve or the compression of a nerve in the foot, leg, or lower back. There may also be a burning or shooting pain that makes it feel like you are walking on pins and needles.

Ganglion Cysts

Ganglion cysts are small lumps located near the foot joints and tendons that are filled with a jelly-like fluid. These small lumps can commonly develop after a foot injury and as we age. A ganglion cyst can cause top-of-the-foot pain if pressed in on the structures of your foot, especially your nerves.

Plantar Fasciitis

Plantar fasciitis can cause heel pain. However, sometimes, the pain can travel to other parts of the foot, including at the top.

Flat Feet

Flat feet can cause pain in the top of the foot due to a lack of arch support. Although pain is usually felt in the arch or heel area, pain may also be felt on the top of the foot.

Toe Deformities

Conditions such as claw, hammer, or mallet toe can cause pain along the top of the foot.

How is Top of Foot Pain Diagnosed?

Pain on the top of the foot can result from many different issues. That is why it is essential to see a professional to receive a proper diagnosis. If your doctor suspects a bone injury after a physical exam is conducted, a diagnostic X-ray will most likely need to be taken.

Treatment Options for Top of Foot Pain

Your individualized treatment to reduce pain will depend on the underlying cause of your pain. Below you will find different treatment options.

Conservative Treatment for Mild Pain and Swelling

Home remedies and conservative treatment may include the following:

• Rest
• Ice
• Anti-inflammatory drugs
• Walking boot
• Modifying your activities

Treatment for More Severe Pain

If you have severe or chronic pain then the following treatments may be recommended:

• Physical therapy or exercises are often part of extensor tendonitis treatment
• Minimally-invasive surgery

It is important to note that most top-of-foot pain can be treated without surgery.

Preventing Top of Foot Pain

Taking good care of your feet is essential for preventing top-of-foot pain. Here are some tips to keep your feet healthy and pain-free:

• Ease into Exercise: Avoid foot injuries by gradually increasing the intensity and duration of your workouts. Starting slow can help your feet adjust and strengthen over time.
• Warm-Up and Cool Down: Before and after exercise, gently stretch the muscles in your feet and calves. Warming up prepares your muscles for activity while cooling down helps to prevent stiffness.
• Rest Your Feet: Give your feet a break, especially if you engage in running, sports, or high-impact activities. Rest days help muscles and joints recover, reducing the risk of overuse injuries.
• Wear Supportive Shoes: Proper footwear is crucial for everyone, but especially for those with diabetes or arthritis. Shoes that fit well and offer good support can prevent pain caused by overuse, sprains, and strains.
• Avoid Going Barefoot: Protect your feet by wearing shoes, and replace them when they start to wear out or become uncomfortable.

By following these simple steps, you can keep your feet in top condition and avoid pain on the top of your foot.

Get Help for Top of Foot Pain Today

Foot injuries can be very uncomfortable and make everyday activities more challenging. Our trained team of specialists at OrthoNeuro is ready to alleviate your pain.

Contact us today in Columbus, OH, or book your appointment online! We look forward to helping you feel your best again.

Medically reviewed by Jeffrey E. Gittins, DO, FAANA