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.

What causes pain on top of the foot?

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: The tendons that run along the top of the foot and pull the foot upwards become inflamed and painful. This is typically associated with walking or running up hills, or at a faster pace than you are used to; essentially, picking up the foot too fast, or too early during gait.
• Sinus tarsi syndrome: This is rare and characterised 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 front of the ankle. Typically when someone has Sinus Tarsi Syndrome, they will actually complain of “ankle pain.” This Syndrome tend to be secondary to an ankle sprain, or those with over-pronation or flat feet.
• Stress fractures of bones in the feet: Pain can result, particularly from fractures in the base of the metatarsal bones, which are located at the top of the feet. This injury will likely have swelling as a symptom, and pain on ambulation.

 

 

Other causes of pain on the top of the foot can include:

• Bone spurs, which are painful growths that form along your joints, in the joints in your feet by your toes.
• Midfoot sprain, which really means that when walking / running the bones are hitting together causing inflammation in the small joints on the top of the foot into the ligaments.
• Peripheral neuropathy, which causes pain, prickling, or numbness that can spread up from the feet into the legs   Peripheral neuropathy typically presents most distally first, meaning it will start in the tips of the digits, and radiate upward to the top of the foot.  Diabetic peripheral neuropathy is always bilateral.
• 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. This can be, but is not always associated with lumbar disc herniation.

Diagnosis

If you have persistent foot pain that lasts longer than a week despite home treatment, you should make an appointment to see your doctor or podiatrist. 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’ll be asked about any other symptoms and potential ways your foot could have been injured. Your physical activity and any past injuries to your feet or ankle will also be discussed.

Your doctor or podiatrist will then examine your foot. They may press on different areas on the foot to see where you feel pain or discomfort. They may also ask you to stand or walk, and evaluate your gait and range of motion. If they suspect a broken bone, fracture, or bone spurs, they’ll order an X-ray of the foot.

Other tests your doctor may run include:

• blood work, which can identify conditions such as gout.
• an MRI to look for stress fractures, joint inflammation, soft tissue injury.
• a nerve conduction test to rule out neuropathy.

Treatment and Prevention

Since 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 home treatments don’t seem to help after a few days, make an appointment with your doctor or podiatrists.

Your feet mirror your general health . . . cherish them!