Pain On Top of Foot

Written By: Chloe Wilson BSc(Hons) Physiotherapy
Reviewed By: FPE Medical Review Board

Pain On Top Of Foot: Symptoms, causes and treatment options

Sudden or persistent pain on top of the foot can be frustrating and impact every step you take.

Most cases are caused by injuries, overuse, wear and tear, or ill-fitting footwear.

Pain can come from the bones, tendons, ligaments, nerves, or even underlying medical conditions. Sometimes swelling or a lump on top of the foot can be the first sign something is wrong.

In this guide, I’ll break down the most common causes of pain on top of the foot, how to recognize them, and the best treatment options to relieve your pain and prevent it from coming back.

Quick Overview: Pain On Top Of Foot

Pain on the top of the foot is often linked to:

  • Tendon issues: extensor tendonitis, tibialis anterior tendonitis
  • Bone problems: stress fractures, tarsal coalition
  • Joint or toe deformities: hammer, mallet, claw toe
  • Medical conditions: gout, nerve issues, ganglion cysts
  • Skin problems: athlete’s foot

Symptoms can range from gradual aching to sudden sharp pain, swelling, tenderness, numbness, or burning sensations.

Top Of Foot Pain Causes & Symptoms

There are lots of possible causes of pain on top of the foot and we will start by looking at the most common and how to tell which one you have. 

Common Causes Typical Symptoms
Extensor Tendonitis Gradual pain, swelling and tenderness on top of the foot, often worse in shoes
Tibialis Anterior Tendonitis Pain at the front of the ankle and top of foot, worse after rest
Stress Fracture Localised sharp pain with swelling, worse during walking or activity
Gout Sudden severe pain, redness and swelling, often starting overnight
Nerve Pain Burning, tingling, numbness or shooting pain on top of the foot
Ganglion Cyst Lump on top of the foot with pressure-related pain or discomfort

1. Extensor Tendonitis

Extensor tendonitis is a common cause of pain on top of the foot. Find out about the causes, symptoms and treatment options

Extensor tendonitis is the most common cause of pain on top of foot that comes on gradually.

With extensor tendonitis there is inflammation of the tendons that run across the top of the foot and contract to lift the toes.

Extensor tendonitis usually causes a gradual increase in pain, swelling & tenderness over the 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.

Find Out More: Extensor Tendonitis

2. Stress Fractures

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

Stress fractures are 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

Stress fractures cause moderate to severe pain, swelling and tenderness over the fracture site.

Most stress fractures are the result of repetitive overloading e.g. kicking, running, jumping or suddenly increasing training levels.

Find Out More: Foot Stress Fractures

3. Tibialis Anterior Tendonitis

Another possible cause of top of foot pain is tibialis 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.

Find Out More: Tibialis Anterior Tendonitis

4. Gout Foot

Gout is a common cause of pain and swelling in the big toe. Find out what causes it and how to treat it

Gout foot is a type of inflammatory arthritis that causes crystal 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 More: Gout Foot

5. Nerve Pain

Pain on top of the foot that is accompanied by altered sensation is often due to  nerve damage 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 where the nerve has become pinched or compressed.

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 More: Nerve Pain In Foot

6. Ganglion Cyst

Foot ganglions can appear anywhere on the foot but are a common cause of a lump or pain on top of foot

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

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. 

Find Out More: Ganglion Cysts or Lump On Top Of Foot

Other Causes Of Top Of Foot Pain

So far we have looked at the most common causes of pain in the top of the foot, but there are some other, less common causes.

1. Sinus Tarsi Syndrome

Sinus Tarsi Syndrome causes pain on top of the foot. Find out about the symptoms, causes and treatment options

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 More: Sinus Tarsi Syndrome

2. Toe Deformities

Hammer, Mallet and Claw Toe result in the toe sitting in an abnormal position. Find out about the common causes, symptoms, diagnosis & treatment options

There are three common toe deformities that cause top of foot pain by altering the positions of the small bones, hammer toe, mallet toe and claw toe.

The most common symptoms are abnormal curling of one or more toes 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 More: Hammer, Mallet, Claw Toes

3. 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.

Find Out More: Tinea Pedis

4. 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.

5. Shin Splints

Pain at the top of the ankle and in the front of the shin is a common problem, particularly in runners. In most cases, it is due to Shin Splints, aka medial tibial stress syndrome.

Repetitive overuse of the shin muscles which help to move the foot causes irritation, inflammation and tenderness in the shin bone. Shin splints are particularly common in people who suddenly increase their activity level, be it frequency, duration or intensity.

Find out all about the common causes, symptoms and best treatment options in the Shin Splints section.

Diagnosing Pain On Top Of Foot

Pain on top of the foot will often settle down, using simple home treatments, within a week. If the pain persists for longer, or is severe, you should see your doctor or physical therapist who may check: 

  • Foot posture and movement
  • Strength, flexibility, and gait
  • Swelling, redness, or deformities
  • Footwear and activity habits

They may also order tests such as X-rays (stress fractures), MRI (soft tissue injuries), or blood tests (gout, infection).

When to See a Doctor

Seek urgent medical advice if you experience:

  • Severe, sudden pain or inability to bear weight
  • Swelling or redness
  • Numbness or tingling
  • Lumps or visible deformities
  • Pain that does not improve within a few days

Associated Symptoms

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:

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: avoid aggravating activities for the first few days
  • Ice: regularly applying ice packs helps to reduce pain and inflammation
  • Medication: over-the-counter painkillers e.g. paracetamol or NSAID's e.g. ibuprofen can help to reduce pain and inflammation
  • Elevation: when resting, prop your leg up so the foot is higher than your heart so gravity can help reduce swelling. Either use cushions, pillows or a special leg elevation cushion
  • Compression Bandage: wearing Tubigrip helps to support the foot and ankle and reduce swelling
  • Gentle Exercises: simple foot exercises such as pumping your feet up and down at the ankles helps to reduce swelling, improve circulation and reduce the risk of muscle weakness and tightness

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: may involve rehab, manual therapy, taping and electortherapy
  • Orthotics: specially designed inserts help to correct abnormal foot position
  • Acupuncture: can help reduce pain and inflammation
  • Crutches: are a good way to rest the foot but still be able to get around
  • Surgery: is not normally necessary for pain on top of foot unless it is something serious or the pain has failed to settle after a few months of treatment

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

FAQ's: Pain On Top Of Foot

Let's look at some of the most frequently asked questions about top of foot pain.

1. Why does my foot hurt on top when I walk?

Pain on the top of the foot while walking is often caused by tendon irritation, stress fractures, or nerve compression. Overuse, tight shoes, and sudden increases in activity can trigger these issues. Adjusting footwear and activity can help, but persistent pain should be evaluated.

2. Can tight shoes cause top of foot pain?

Yes. Shoes that are too tight or have poor support can compress tendons and nerves, causing tenderness, burning, or swelling on top of the foot.

3. Is top of foot pain a sign of a serious problem?

Most causes are minor and improve with rest and supportive care, but sudden severe pain, swelling, or inability to bear weight may indicate a stress fracture, gout flare, or nerve issue. These cases need prompt medical assessment.

4. How can I prevent pain on top of the foot?

Prevention includes well-fitting shoes, proper arch support, gradual increases in activity, and stretching and strengthening exercises for the foot and ankle. Avoid repetitive high-impact activity without conditioning.

5. Why does my top of foot hurt more at night?

Pain at night is often related to gout or nerve irritation, which can flare while you’re at rest. Tendonitis pain usually worsens with movement, while gout often hits suddenly at night.

6. Can top of foot pain come from my back or leg?

Yes. Nerve compression in the lower back or leg can refer pain to the top of the foot. This is often accompanied by tingling, numbness, or burning sensations.

What Else Can Help?

The most common causes of pain on top of foot are extensor tendonitis, stress fractures, overuse, injuries, bone problems or underlying medical conditions.

Here, we have looked at the 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. If you have any lumps or bumps on top of your foot, check out the top of foot lumps article.

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. If you have pain in another area of your foot, check out the following articles:

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References

  1. Pain In The Top Of The Foot. NHS UK
  2. Current And Future Advances In Practice: Mechanical Foot Pain. Rheumatology Advances In Practice
  3. Management Of Extensor Tendon Injuries. The Open Orthopaedics Journal
  4. Pain In The Top Of The Foot. NHS UK

Page Last Updated: 6th January, 2026
Next Review Due: 6th January, 2028