Why Does the Top of My Foot Hurt?

Medically reviewed by:

Ralph Napolitano, Jr., DPM, CWSP, FACFAS
Director, Wound Care and Healing
Lower Limb Medicine, Surgery and Wound Care

Recently you have been feeling an unusual pain. It is a random top of foot pain that you have difficulty describing. You keep a healthy diet and are active, so you are confused about what it could be. If you find yourself in this situation, do not worry.

Our highly trained foot, ankle, and podiatry specialists at OrthoNeuro can help. Contact one of our conveniently located offices in Columbus, OH today.

We understand that you may have some basic questions regarding why the top of your foot is hurting. To get you started, we have provided some of the answers for you.

Why Do I Have Pain on Top of My Foot?

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. We will discuss 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 & 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 when the tendons on the top of the foot 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 pain can begin at the base of your big toe 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 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 

Peripheral neuropathy produces pain on top of the foot that 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.

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, an 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 Minimal Pain and Swelling:

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

Treatment for More Severe Pain:

  • Physical therapy or exercises
  • Minimally-invasive surgery

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

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.

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

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