Top of Foot Pain

Foot Pain

Our feet are not only bones and muscles, but they also have ligaments and tendons, too. Feet carry our body weight all day every day! So no surprise foot pain is very common!

Sometimes, you might feel pain at the top of your foot that is uncomfortable when walking and even standing still. The degree of this pain depends on the cause and if there are any associated injuries.

What causes pain on top of the foot?

Most common causes are due to overuse in activities like running, jumping, or kicking.

Conditions caused by overuse include:

  • Extensor tendonitis: Pain and inflammation of the tendons that run along the top of the foot and bring the foot upwards become. This might typically occur when walking or running up hills or at a faster pace than that which you are used to.
  • Sinus tarsi syndrome: This is rather uncommon and is caused by an inflamed sinus tarsi. This is the channel found between the heel and the ankle. This causes pain on the top of the foot and front of the ankle. Typically people will actually complain of “ankle pain.” Sinus Tarsi Syndrome can also occur secondary to an ankle sprain or  in individuals with over-pronation or flat feet.
  • Stress fractures: Pain from fractures that occurred in the base of the metatarsal bones. Obviously there is a history of an injury and the patient will likely have swelling and pain on walking.

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

  • bone spurs, painful outgrowths that form along your joints, and in the joints in your feet
  • Midfoot sprain, also occurs following a sprain during walking / running and thus the bones are hitting together causing inflammation in the small joints on the top of the foot and into the ligaments.
  • Peripheral neuropathy, commonly in diabetics, causing pain, burning, and/or numbness that spreads up from the feet into the legs. So it starts most distally first, meaning it will start in the tips of the digits and then continue upward to the top of the foot.  Diabetic peripheral neuropathy is always bilateral.
  • Common peroneal nerve dysfunction, this is a problem occurring in 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.

 

How is the pain diagnosed?

Persistent foot pain lasting longer than a week despite initial treatment, should make you see your doctor. Especially if your pain is severe enough to keep you from walking, or if this pain is burning pain, numbness, or tingling on the affected foot.

Your doctor will ask you about other symptoms and ways your foot could have been injured. He may also ask about your physical activity and any past injuries to your feet or ankle.

Your doctor will then examine your foot. This is a very important and necessary step to help in the diagnosis of the cause and to aid your doctor in knowing which imaging modalities to choose for your condition. He may also ask you to walk and perform certain tests both dynamically and at rest.

Your doctor will then choose the appropriate diagnostic imaging modality according to your condition.

Other tests your doctor may run include:

  • blood tests, which can identify conditions such as gout, rheumatic conditions etc
  • an MRI possibly to look for stress fractures, joint inflammation, soft tissue injury.
  • EMG/ NCV (nerve testing) to rule out neuropathy or radiculopathy.

TREATMENT

How is the pain treated?

Because feet support all our body weight, a simple injury could become a more severe one if it is neglected. Kindly see your doctor as soon as you can.

Treatment depends on the underlying cause of the condition. Thus treatment might include items like :

  • physical therapy, which can help in problems 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.

Generally for mild cases of foot pain, you should rest and avoid bearing weight on the foot as much as possible. Apply ice to the painful area for twenty minutes at a time, but no more, maybe three times a day. If you do have to walk, wear supportive, well-fitting shoes that aren’t too tight.