Pain On Top Of Foot

If your doctor suspects a broken bone, fracture, or bone spurs, they’ll order an X-ray of the foot.

Why Do I Have Pain on Top of My Foot?

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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.

Last medically reviewed on May 18, 2017

Pain On Top of Foot

Pain on top of the foot is a common problem. Every step we take places a force 1.5x body weight through our feet so it’s no wonder our feet get sore!

Most cases of pain on top of the foot are due to either an injury, overuse, wear and tear or even ill-fitting footwear. Pain may be due to a problem in the bones, soft tissues or various medical conditions. There may even be a top of foot lump.

We are going to look at the common causes of pain on top of the foot, how they present and the best ways to treat them.

Common Causes Of Top Of Foot Pain

The most common causes of pain in the top of the foot are due to damage to the:

Bones: e.g. stress fractures, sinus tarsi syndrome, toe deformities & tarsal coalition
Soft Tissues: e.g. extensor tendonitis or tibialis anterior tendonitis
Skin: e.g.athlete’s foot
Medical Conditions: e.g. gout, ganglions or nerve damage

Here we will look at the most common causes of pain on top of foot and how to tell which one is causing your foot problem, then we’ll go on to look at how to treat them.

1. Stress Fractures

$Stress fractures are a common cause of pain on top of the foot. Find out about the causes, symptoms, diagnosis & treatment options$

A stress fracture is a common cause of pain on top of the foot caused by a small break in one of the foot bones e.g. metatarsal fracture

2. Sinus Tarsi Syndrome

Sinus tarsi syndrome is a common cause of ongoing pain on top of foot after an ankle sprain. With sinus tarsi syndrome there is inflammation of the small, bony channel between the heel & ankle.

Common symptoms include ankle stiffness, instability, pain on outer side of the top of the foot when walking or standing.

Sinus tarsi syndrome most often develops after an ankle sprain but may also be due to prolonged instability and altered foot biomechanics

Find out all about the common causes, symptoms, diagnosis and treatment options in the Sinus Tarsi Syndrome section.

3. Hammer, Claw & Mallet Toe

There are three common toe deformities that cause top of foot pain by altering the positions of the small bones

The most common symptoms of these toe deformities are abnormal curling of one or more toe which may or may not be accompanied by stiffness and pain.

Toe deformities often develop from wearing tight, pointed shoes but may also be caused by a toe injury, problems in nerves or blood vessels or arthritis

Find out all about these common toe deformities, how to tell which one you have and how to treatment them Hammer, Mallet, Claw Toes section.

4. Extensor Tendonitis

Extensor tendonitis is one of the most common causes of gradual onset pain on top of foot. With extensor tendonitis there is inflammation of the tendons on the top of the foot that contract to lift the toes.

Extensor tendonitis usually causes a gradual increase in pain, swelling & tenderness over top of foot and there is often discomfort when wearing shoes due to pressure on the tendons

Tight shoes, flat feet, prolonged standing/walking, muscle tightness and off-road running are common causes of extensor tendonitis.

You can find out all about this common cause of pain on top of foot, including the causes, symptoms and treatment options in the Extensor Tendonitis section.

5. Tibialis Anterior Tendonitis

Another possible cause of top of foot pain is tibilais anterior tendonitis. This is where there is inflammation of the tendon at the front of the ankle that lifts up the foot.

Tibialis anterior tendonitis usually causes a gradual increase in pain on top of foot and at the front of ankle which often feels worse after resting.

Common causes incude overuse e.g. running, esp. off-road or downhill and muscle weakness & tightness.

You can find out all about the common causes, symptoms and treatment options in the Foot Tendonitis section.

6. Gout Foot

Gout is a type of inflammatory arthritis that causes crystals formation in joints e.g. big toe, due to high uric acid levels.

Gout foot causes a sudden onset of intense pain in the big toe and on top of the foot (typically at night), redness, heat and swelling in the foot.

You are more at risk of developing foot gout if you have a purine-rich diet (lots of red meat), have a family history of gout, are overweight or have diabetes.

Find out all about the causes and symptoms of gout and how to treat and prevent it in the Gout Foot section.

7. Athlete’s Foot

One of the less common causes of pain on top of the foot is Athletes Foot, a fungal infection of the skin. Also known as tinea pedis it affects approximately 15% of the world’s population.

Athlete’s foot results in scaly, itchy, flaking skin, swelling and blistering which can cause pain on top of the foot.

It normally develops due to poor foot hygiene, excess moisture, humid conditions and is highly contagious.

You can find out all about the causes, symptoms and treatment options in the Foot Rashes section.

8. Nerve Pain

Pain on top of the foot that is accompanied by altered sensation is often due to pinching or compression of nerve in the foot, leg or lower back.

There may burning or shooting pain along the top of the foot, pins and needles, numbness and/or foot weakness

Nerve injuries usually originate from swelling, injury, spinal deformity or disc bulge in the lower back. There is often no actual pain in the back itself, the symptoms may only be felt in the foot.

Find out all about the causes, symptoms, diagnosis and treatment options in the Nerve Pain In Foot section.

9. Ganglion Cyst

Pain on top of the foot that is accompanied by a lump is often due to a ganglion.

Ganglion cysts are small lumps filled with jelly-like fluid often found near the foot joints & tendons.

They are small, pea-like nodules that can causes pain if the press on nearby structures in the foot, particularly nerves.

Often there is no obvious reason why ganglion cysts develop but they are more common after a foot injury or as we age.

10. Tarsal Coalition

Tarsal coalition is a rare cause of pain on top of the foot affecting only around 1% of the population.

With tarsal coalition, a bony bridge forms between two or more of the foot bones. This leads to stiffness, instability and foot pain, typically in early adolescence.

Tarsal coalition is a congenital condition (present since birth) and is often hereditary.

Find out all about the common causes, symptoms and treatment options in the Tarsal Coalition section.

You can find out loads more about each of these conditions, including the best treatment options for each one, by using the links above.

Diagnosing Pain On Top Of Foot

Much of the time, pain on top of the foot will settle down, using simple home treatments, within a week. If the pain persists for longer, or is severe, you should see your doctor.

The doctor will ask you:

when your top of foot pain started
how it started
if you have any other symptoms
about any past foot or ankle injuries
your normal activity levels
what things make the pain better or worse
if there is any pattern to your pain

Then, they will examine your foot for any signs of swelling or deformity. The will look at you walking and then look at the movement and strength in and around your foot.

If the doctor suspects a bony injury, you will be sent for an x-ray. They may also order blood tests or an MRI.

What’s Causing My Top Of Foot Pain?

Pain on top of the foot is often accompanied by other symptoms which can help you to work out what is causing your top of foot pain:

Mild-Moderate Pain On Top Of Foot (Gradual Onset):extensor tendonitis (top of foot), tibialis anterior tendonitis (front of ankle)
Stiffness and Instability:sinus tarsi syndrome (after ankle sprain), tarsal coalition (early adolescence)
Severe, Sudden Pain:stress fracture (day), gout (night)
Top Worse after Rest:tendonitis
Worse with Activity:stress fracture , sinus tarsi syndrome , tendonitis
Abnormal Toe Curling:hammer, mallet or claw toe
Redness Big Toe:gout
Lump On Top Of Foot:ganglion,stress fracture
Itchy, Flaking Skin:athlete’s foot
Pins and Needles or Numbness:nerve problem

Treating Pain On Top Of Foot

Treatment for pain on top of the foot will depend on what the underlying cause is. If it is a minor problem with minimal pain and swelling, you can usually treat your top of foot pain at home with a combination of:

Rest
Ice
Anti-inflammatories
Elevation
Compression Bandage (Tubigrip)
Gentle exercises
Reducing your activity levels

If the foot pain is more severe, is getting worse, there is a lump on top of foot, significant swelling or you are unable to bear weight, you should see you doctor. They may then advise:

physical therapy
orthotics
acupuncture
crutches
surgery (rare)

You can find out loads more about how to reduce pain on top of the foot in the foot pain treatment section.

What Else Can Help?

Here, we have looked at the ten most common causes of pain on top of foot. Any new incidence of pain should always be assessed by your doctor to ensure an accurate diagnosis.

To find out more about these common causes of pain on top of foot, choose the appropriate link above. Or, if you want some help working out what is causing your top of foot pain, visit the foot pain diagnosis section.

Page Last Updated: 09/14/22
Next Review Due: 09/14/24

Diagnosis

Symptoms

Symptoms Guide
Blisters
Burning Foot Pain
Cramp
Foot Lumps & Bumps
Foot Rashes
Foot Numbness
Foot Pain Running
Foot Swelling
Sharp Toe Pain
Thick Toenails
Yellow Toenails

Injuries

Common Injuries
Tendonitis Guide
Achilles Tendonitis
Bursitis
Cuboid Syndrome
Extensor Tendonitis
Peroneal Tendonitis
Posterior Tibial Tendonitis
Plantar Fasciitis
Sinus Tarsi Syndrome
Sprained Ankle
Stress Fractures
Tennis Toe

Conditions

Blue Toe Syndrome
Bunions
CMT Disease
Corns & Calluses
Foot Eczema
Gout Foot
Haglund’s Deformity
Heel Spurs
Mortons Neuroma
Os Trigonum
Plantar Fibromatosis
Tarsal Coalition
Tarsal Tunnel Syndrome
Toe Deformities
Toe Cyst
Trench Foot
Turf Toe

Treatment

Treatment Guide
Bone Spur Treatment
Bunion Treatment
Bunion Splints
Foot Rashes
Gout Prevention
Ice Therapy
Ingrown Toenails
Orthotics
Plantar Fasciitis
Plantar Fibroma
Reflexology
Sprained Ankle
Swollen Feet
Toe Stretchers

Exercises

Exercise Guide
Strengthening Exs
Stretches
Calf Stretches
Calf Strengthening
Heel Stretches
Plantar Fascia Exs

Anatomy

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Why does the top of my foot hurt?

The foot has a complex set of tendons, muscles, joints, and bones that enable it to work properly, as well as withstand walking, standing, and other everyday movements.

Many health conditions and injuries, however, can upset the foot’s movement and balance, causing problems and pain.

Pain on top of the foot may seem like an unusual location, particularly if no obvious injury took place there. However, this area can be affected by a variety of conditions and injuries beyond a bone fracture or bruise.

Most foot pain requires, at the very least, rest and extra care to heal. If the pain is due to an underlying health condition, additional medical care may be needed.

Taking note of the pain and symptoms and what came before the problem can help determine the cause. This ensures that correct treatment can be given.

An injury, such as a sprain or bone break, can occur in any part of the foot, including the top.

Problems with the top of the foot can be due to dropping something on the area. There can be other, less obvious causes, however.

Lisfrank or midfoot injury

The middle of the foot is known as the Lisfrank area or midfoot. This area is made up of a group of small bones that help form the foot’s arch.

If one of the midfoot bones is broken or a tendon is inflamed or torn, it may cause pain, swelling, bruising, and redness on the top of the foot.

Midfoot injuries can be caused by accidents, such as a heavy object landing on the foot.

Not all midfoot injuries are due to dropping something or getting the foot stepped on, however. They often occur when someone falls with the foot flexed downward, pulling or straining tendons or fracturing bones.

A hairline or stress fracture can also happen in this area due to overuse, such as from long periods of running or high-impact activity.

Midfoot injuries can be mild to severe, depending on how many tendons or bones are injured. Mild tendon injuries may only require RICE (rest, ice, compression, and elevation) until the tendon has healed.

Severe injuries and bone fractures may require a cast, physical therapy, or surgery.

Fracture of fifth metatarsal

Pain on the outside of the top of the foot is often related to the fifth metatarsal. This is a long bone that connects the little toe to the middle of the foot.

Several types of fractures may occur in the fifth metatarsal:

Avulsion fracture: This occurs when a tendon or ligament pulls a small piece of the fifth metatarsal out of place. An avulsion fracture often occurs with an “ankle roll” injury and may happen along with an ankle sprain.
Jones fracture: This type of break often occurs near the top of the fifth metatarsal, close to the outside and middle area of the foot. It can be a small hairline fracture caused by repeated stress and strain on the foot, or it can be a more severe break due to an injury or fall.
Midshaft fracture: This type of break is often due to an accident or twisting of the foot. It occurs near the middle of the fifth metatarsal.

Fifth metatarsal breaks usually require medical care. Staying off the foot and using RICE is recommended right after the injury. Additional care, such as a cast, boot, or crutches, may also be required.

Surgery can be recommended if:

the bone is displaced
there are multiple breaks in the fifth metatarsal or other areas of the foot
the fracture is not healing as expected

Extensor tendinitis

Tendinitis can occur in many different areas of the feet and legs. The extensor tendons, located in the top of the foot, are needed for flexing or pulling the foot upward.

If they become inflamed due to overuse or wearing shoes without proper support, they may get torn or inflamed. This is known as extensor tendinitis, which can cause significant pain in the top of the foot.

Extensor tendinitis pain usually gets worse with activity, and may also occur alongside swelling of the top of the foot. It may come about after excessive exercise or doing too much exercise, too soon.

The condition can be quite painful, but can often be treated with:

rest, with or without splinting
non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen
steroid injections
physical therapy or exercises

Once the tendon feels better, it is best to ease back into activity slowly to avoid inflaming or injuring the tendon again.

Ganglion cyst

A ganglion cyst forms below the surface of the skin, appearing like a bump or sac filled with fluid.

It often forms on top of the foot and may happen after an injury to the area. The cause of these cysts, however, is not always known.

A ganglion cyst can cause pain if it is pressing against a muscle or joint in the foot. It may also cause tingling or burning if it is located near a nerve. If the cyst is large, it can cause discomfort or pain when it rubs against shoes.

Treatment for a ganglion cyst depends on how much pain it causes:

Small cysts that are not causing pain can follow a “wait and see” approach.
Pads or special footwear can be used to avoid rubbing and irritation of the cyst.
A cyst can be aspirated, where the fluid is removed with a needle. Sometimes, however, the cyst comes back after this treatment.
Severe, painful cysts can be removed with surgery.

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