Pain on the Top of Your Foot: Causes and Treatments

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Pain on the Top of  FootYou can experience a sharp pain on the top of your foot when walking, running, or even standing still. It can be a throb, an ache, or a burning pain on the top of your foot, but no matter when or how you experience it, it can be a very disrupting and irritating sensation, but also a confusing one since it isn’t always a simple case of having your laces tied too tightly.

Understanding this problem and its solutions, is fortunately a relatively simple matter, albeit one with some accompanying explanations.

Why the Top of the Foot?

Let’s start with the most basic question: why is the pain coming from on top of your foot? The answer requires some slight explanation of anatomy. The foot is composed of numerous bones, ligaments, muscles, and tendons, almost all of which are closer to the top of your foot than the sole.
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For example, the flexor muscles that help you lift, curl, and otherwise stabilize your toes run from near the toes to the upper part of the ankle, traveling along the top portion of your foot. Similar arrangements can be found in the tendons and ligaments as well. When bones are considered, only the heel can be considered to be entirely on the bottom.

With this layout in mind, it becomes more understandable why a problem in your foot might result in pain along the top.

What Causes Pain on the Top of the Foot?

Due to how the foot’s anatomy is arranged, there are many forms of injury or ailment that can create pain on top. Here are some more common culprits.

  • Stress fracture: This is one of the more frequent causes of sudden-onset top-of-foot pain and usually happens when there is a tiny break in one of the metatarsals, the bones that connect the toes to the ankle. Stress fractures are the result of overuse, especially if you undergo a sudden increase in physical activity. The pain in this case can be quite severe and the foot will experience swelling while being tender to the touch.
  • Ganglion cyst: A cyst is a fluid-filled capsule, and a ganglion cyst is one that forms around the joints or tendons of the foot. They are caused by aging or when fluid escapes from a joint during injury, but they can also arise spontaneously. Most ganglion cysts are harmless and don’t present symptoms—you might have one right now and not know it. However, if the cyst ends up pressing against something sensitive like a nerve, pain results. A ganglion cyst, even a pain-free one, will present as a small swollen spot that can range from the size of a pea to being as large as a golf ball.
  • Osteoarthritis: One of the possible effects of arthritis is that it can cause the arch of your foot to collapse over time and flatten. Due to how the joints are arranged in your foot, this can result in pain being felt closer to the top than the sole, especially if the affected joints are connected to the toes.
  • Tarsal coalition: This happens more often among children and young adults. You have about 300 bones when you are born, but as you grow they fuse to become the 206 we all know and love. In cases of tarsal coalition, two foot bones that are normally separate have decided to get in on the action and fuse together. This affects how well the feet can flex and more often than not results in pain on the upper side. Other symptoms include stiffness in the feet below the ankle, a rigid or flat foot that results in rolling the ankle more frequently, and possibly limping following periods of high activity.
  • Tendonitis: The inflammation of a tendon. Specifically, the tibialis anterior tendon, which connects to the ankle, though other tendons can be affected as well. Tendonitis can be caused by a few different sources, including tying your shoes too tightly. It is, however, more commonly seen as a form of repetitive stress injury, especially if you have pain on top of the foot after running along uneven surfaces. The pain will usually be localized along the top of the foot and the ankle and worsens after activity and while resting. Exertion of the tendon, like when kicking a ball, will be particularly painful.
  • Trauma: An obvious cause, but one that should be mentioned. Any injury to your foot is capable of causing trauma that brings about top-of-foot pain. This includes fractures, sprains, torn muscles or ligaments, bruises, improperly sized shoes, ingrown nails, and dropping something heavy on your foot.

How to Treat Pain on Top of Your Foot

Unless you want to take some painkillers and call it a day, addressing the pain on the top of your foot is going to require addressing the underlying problem:

  • Stress fractures: Rest is extremely important, since weight needs to be kept off the foot while it heals. Ice can ease the swelling and pain and your doctor may want you to wear a brace during the healing process. Medication can also help the swelling and inflammation. In some cases, you may need surgical repair but this is fortunately uncommon.
  • Ganglion cyst: The cyst will go away on its own, though this can take several years. Since this isn’t a good timeframe for recovery, the cyst can also be deflated by having the fluid within extracted via needle. Alternatively, surgery can be performed to remove it. Unfortunately ganglion cysts have a habit of returning in about 20% of cases.
  • Osteoarthritis: Although not currently curable, arthritis pain can be remedied by hot/cold temperature therapy, keeping weight off the foot when it begins to act up, and maintaining a healthy weight to reduce pressure on the joint.
  • Tarsal coalition: Resting the foot following high-impact activity can be used to ease symptoms. Orthotic inserts to can also be employed to support and stabilize the foot. The only long term, permanent cure however is surgery to separate the fused bones.
  • Tendonitis: Much like a stress fracture, rest, ice, exercise, and prescribed drugs can be used to ease symptoms. Orthotics may also be called for and surgical repair is used in more advanced cases or ones that are proving resistant to treatment.

Effective Exercises to Treat Pain on the Top of Your Foot

Here are two quick exercises you can try when recovering from the pain on top of your foot. Speak to your doctor or physical therapist about other forms of exercise you can try to improve your recovery and strengthen the foot.

  • Plantar fascia stretch: Sit down on a chair and rest the arch of your foot on a round object like an exercise bar or even a soda can. Roll the arch of the foot along the chosen object back and forth for three minutes at least twice per day.
  • Achilles tendon stretch: Sit down on the floor or on a mat with your legs extended and loop a towel around either the top of your foot or the ball of the heel. While keeping your knees straight, pull on the towel to bring your foot towards you and hold for about 30 seconds. Repeat three to four times per day.

Sources for Today’s Article:
“What Causes Pain on the Top of Your Foot?” Better Health Tips web site, 2014; http://www.betterhealthtips.org/what-causes-pain-on-the-top-of-your-foot/, last accessed February 11, 2016.
“Pain on Top of Foot: Causes, Symptoms & Treatment,” Foot-Pain-Explored.com; http://www.foot-pain-explored.com/pain-on-top-of-foot.html, last accessed February 11, 2016.
“Osteoarthritis Treatments,” Healthline web site; http://www.healthline.com/health/osteoarthritis-treatment?ref=tc#Treatments1, last accessed February 11, 2016.
“Tarsal Coalition,” American Academy of Orthopaedic Surgeons web site; http://orthoinfo.aaos.org/topic.cfm?topic=A00708, last accessed February 11, 2016.
“Top of the Foot Pain: Treatment, Exercises, Causes, Symptoms,” EPainAssist.com; http://www.epainassist.com/joint-pain/foot-pain/top-of-the-foot-pain, last accessed February 11, 2016.
“How Much Do You Know about Bones?” WebMD web site; http://www.webmd.com/osteoporosis/features/how-much-do-you-know-about-bones?page=2, last accessed February 11, 2016.


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Dr. Alwyn Wong, DC

About the Author, Browse Alwyn's Articles

Dr. Alwyn Wong has been involved in the health and fitness industry for over fifteen years and brings with him a wealth of experience. He uses an integrated treatment approach, combining active release techniques (ART®), acupuncture, chiropractic, nutritional consulting, and program design to treat his patients, many of whom have included professional athletes from the NFL, NHL, NBA, MLB, and PGA, as well as Olympic, and IFBB athletes. Although his focus has shifted to more clinical work, he remains as... Read Full Bio »