Pain On Top of Foot

Author: Chloe Wilson - BSc(Hons) Physiotherapy

Pain on top of the foot is a common problem. Every step we take places a force 1.5x body weight through our feet. 

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 in the top of the foot may be caused by damage to the:

Bones: e.g. stress fractures, Sinus Tarsi Syndrome, Hammer, Mallet or Claw Toe & 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

Stress Fractures

Small break in one of the foot bones e.g. metatarsal fracture

Symptoms: Severe pain, swelling and tenderness over the fracture

Cause: Repetitive overloading e.g. kicking, running, jumping, increased training 

Full Article: Foot Stress Fractures

Sinus Tarsi Syndrome

Inflammation of the small, bony channel between the heel & ankle

Symptoms: ankle stiffness, instability, pain when walking/standing on top and side of foot

Cause: Ankle sprain, prolonged instability, altered foot biomechanics

Full Article: Sinus Tarsi Syndrome

Hammer, Claw & Mallet Toe

Toe deformities which alter the positions of the small bones

Symptoms: Stiffness, pain and abnormal curling of one or more toe

Causes: Tight, pointed shoes, toe injury, problems in nerves or blood vessels, arthritis

Full Article: Hammer, Mallet, Claw Toes

Tarsal Coalition

Bony bridge connecting two or more of the foot bones. Affects approx. 1% of the population

Symptoms: Stiffness, instability and foot pain, typically in early adolescence.

Causes: Congenital condition (present since birth), often hereditary

Extensor Tendonitis

Inflammation of the tendons on the top of the foot that lift the toes

Symptoms: Gradual increase in pain, swelling & tenderness over top of foot. Discomfort when wearing shoes

Cause: Tight shoes, flat feet, prolonged standing/walking, muscle tightness, off-road running

Full Article: Extensor Tendonitis

Tibialis Anterior Tendonitis

Inflammation of the tendon at the front of the ankle that lifts up the foot

Symptoms: Gradual increase in pain at front of ankle and top of foot, worse after rest

Cause: Overuse e.g. running, esp. off-road or downhill, muscle weakness & tightness

Full Article: Foot Tendonitis

Gout Foot

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

Symptoms: Sudden onset of intense pain (typically at night), redness, swelling, heat

Causes: purine-rich diet, hereditary, obesity and often linked with diabetes

Full Article: Gout Foot

Ganglion

Small lump filled with jelly-like fluid, found near foot joints & tendons

Symptoms: Small, pea-like nodule. Causes pain if presses on nearby structure e.g. nerve

Cause: Foot injury, aging, often unknown origin

Athlete's Foot

Fungal infection of the skin, tinea pedis. Affects approx 15% population

Symptoms: Scaly, itchy, flaking skin, swelling and blistering

Cause: Poor foot hygiene, excess moisture, humid conditions, contagious

Full Article: Foot Rashes

Nerve Pain

Pinching or compression of nerve in the foot, leg or lower back Symptoms: burning or shooting pain, pins and needles, numbness, foot weakness Cause: Swelling, injury, spinal deformity, disc bulge Full Article: Nerve Pain In Foot

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 the 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.

Commonly Associated Symptoms

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

• Gradual Onset Mild-Moderate Pain: extensor tendonitis (top of foot), tibialis anterior tendonitis (front of ankle)

• Severe, Sudden Pain: stress fracture (day), gout (night)

• Stiffness and Instability: sinus tarsi syndrome (after ankle sprain), tarsal coalition (early adolescence)

• 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

• Small Lump: 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 yourself at home with a combination of:

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

If the pain is more severe, is getting worse, there is 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 Next?

Here, we have looked at 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.

Go to Diagnosis Overview or Foot Pain Guide