Author: Chloe Wilson - BSc(Hons) Physiotherapy
Pain on top of the foot can really affect our daily lives, affecting activities like walking, running and simply standing. Our feet are one of the hardest worked parts of our bodies – with each step, a force of 1.5 times body weight goes through the foot.
It comes as no surprise that approximately 75% of Americans have foot pain at some point in their lives. There are a number of causes of top of foot pain. There may be an injury to one of the foot bones, a problem in the soft tissues or the pain may be referred from further up the leg or from the lower back.
Here we will go through a brief overview of the ten most common causes, looking at the symptoms and treatment options for each type of pain on top of foot. To find out more about each one, use the relevant links below.
The most common cause of sudden top of foot pain without a specific injury
What Is It: A small break in one of the foot bones, commonly one of the metatarsals
Causes: Repetitive overloading of the foot e.g. jumping, kicking and running especially if there is muscle weakness and tightness or a sudden increase in activity levels
Symptoms: Pain on top of foot which can be quite severe. Tender to touch and swelling around the area
Treatment Options: Rest (you may need crutches to keep the weight off your foot for a couple of weeks), ice, ankle/foot brace, medication and occasionally surgery
Find out more about how to treat and prevent this common cause of top of foot pain in the Stress Fractures section.
What Is It: Irritation and inflammation of the tendons on the top of the foot
Causes: Shoes that are too tight, calf tightness, spending long periods on your feet, altered foot biomechanics, walking/running on uneven surfaces or simply dropping a heavy object on your foot
Symptoms: Gradual onset of swelling, bruising and pain on top of foot. Tender to touch and may be uncomfortable wearing shoes
Find out more about how to abolish the pain in top of foot and prevent the problem from recurring in the Extensor Tendonitis section
This more uncommon foot problem tends to cause localised pain around the top of the foot towards the outside of the ankle
What Is It: Inflammation and irritation around the Sinus Tarsi, a small channel between the ankle and heel bone that ligaments, blood vessels and nerves pass through
Causes: It most commonly occurs due to instability, often the result of an ankle sprain. It can also be caused by poor foot biomechanics, or repetitive activities such as ballet and baseball
Symptoms: Foot pain on top and outside of the ankle which gets better with rest and worse with activity. Ankle stiffness in the morning which eases with movement. Instability and tenderness to touch
Treatment Options: Ice, exercises, joint mobilisations, stability training. Complete rest from all aggravating activities is vital
Visit the Sinus Tarsi Syndrome section to find out more about how to treat this common cause of pain on top of foot.
These are the most common cause of top of foot pain affecting the toes.
What Are They: Deformities in the toes affecting the positions of the small toe bones
Causes: Poor fitting footwear is the most common cause of this type of top of foot pain, either high heels or shoe with a narrow toe. They can also develop secondary to a toe injury, a neural or vascular problem or arthritis
Symptoms: Pain and stiffness in the toes. Abnormal toe positions.
Associated Problems: Corns and calluses often develop on the toes secondary to Hammer, Claw and Mallet toe
Find out more about how these three conditions present, how to tell the difference between them and how to treat them in the Hammer, Claw & Mallet Toe section.
Another common cause of pain on top of foot, especially around the big toe
What Is It: A type of inflammatory arthritis due to high levels of uric acid which cause crystals to form in joints, most commonly the big toe
Causes: Certain medical conditions such as diabetes make you more prone to developing gout, diet (food and drink rich in purines), obesity and genetics
Symptoms: Sudden onset of intense pain, swelling, redness, heat and tenderness, commonly starting at night time. Symptoms usually settle within a couple of weeks
Treatment Options: Medication, ice, steroids
Find out more including some great ideas on how to prevent gout attacks in the foot gout section.
What Is It: Occurs when a nerve supplying the top of the foot gets pinched or squashed either in the foot itself, further up the leg or in the lower back
Causes: Swelling from an injury to the foot, tight footwear, or dropping something heavy onto the top of the foot
Symptoms: Shooting or burning pain on top of foot sometimes accompanied by pins and needles and/or numbness
Athlete’s foot can occur anywhere on the foot and affects approximately 15% of the population globally at some point in their lives.
What Is It: A fungal infection of the skin aka tinea pedis
Causes: Poor foot hygiene. Anything that increases the moisture around the foot e.g. wearing tight shoes, damp socks, warm humid conditions. Athlete’s foot is contagious and can be passed from person to person or via contaminated surfaces e.g. towels, floors and showers
Symptoms: Foot pain on top, side and bottom. Scaly and flaking skin which is often itchy. If left untreated, can develop swelling and blisters
Treatment Options: Good hygiene measures, going barefoot, anti-fungal medication, tea-tree oil. If left untreated the condition can get so bad that amputation is required
What Is It: Small area of swelling that is filled with jelly-like fluid, usually around the joints of tendons in the foot. They are generally harmless
Causes: Can be related to aging or may develop after an injury when fluid escapes from the joint capsule and pools in the nearby soft tissues forming a ganglion cyst. Often there is no obvious cause
Symptoms: Small ball of swelling ranging from the size of a pea to a golf ball. Often pain-free unless it is pressing on a nearby structure e.g. a nerve
Treatment Options: Many disappear over time without any treatment (can take years). The fluid can be removed with a needle, known as aspiration or the ganglion can be surgically removed but in both cases they recur in 1-in-5 people
What Is It: Tarsal Coalition is where two or more of the tarsal bones in the foot are joined together with a bridge of bone. Affects approximately 1% of the population
Causes: This is a congenital problem (i.e. present since birth) and often displays a genetic link
Symptoms: Usually affects children aged 10-15 years old causing foot pain, stiffness and instability
Associated Problems: Can cause recurrent foot and ankle sprains and abnormal foot biomechanics e.g. flat feet
Treatment Options: Orthotics, immobilisation in a cast, surgery
What Is It: Inflammation and degeneration of the Tibialis Anterior Tendon at the front of the ankle
Causes: Overuse or excessive stress through the tendon e.g. running, kicking and snowboarding particularly going downhill or on uneven surfaces. Muscle weakness and tightness, poor foot biomechanics, inappropriate exercise technique
Symptoms: Pain on top of foot and front of the ankle. Worse after activity or prolonged rest. Symptoms usually come on gradually
Associated Problems: Actions such as kneeling or kicking a ball are often painful
These are the ten most common causes of pain on top of foot. And 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 pain, visit the foot pain diagnosis section.