Healthy Living

What Could Pain on Top of the Foot Mean?

There are a number of potential causes of foot pain depending on its severity and location, and knowing some of its causes helps.

What Could Pain on Top of the Foot Mean?

The foot comprises flexible structures of soft tissues, muscles, joints, and bones that enable us to stand, walk, and perform other daily movements. However, certain injuries and a number of health conditions can impair the balance and movement of the foot, causing pain and other problems.

The pain may range from mild to severe, depending on the extent of injury, location, and cause. Sometimes, knowing its potential causes can effectively help relieve the pain. Taking rest, limiting activities, taking oral anti-inflammatory medications, and using functional orthotics can be helpful. Surgery is rarely needed.

7 Causes of Pain on Top of the Foot

1. Stress Fracture

If there is no specific injury, then the most common cause of a sudden pain on the top of the foot is a stress fracture. In a stress fracture, one of the bones of the foot breaks. It also commonly affects the metatarsals of the foot. A stress fracture may also occur when there is an overuse or repetitive force to the feet when jumping, running, or kicking, especially when the muscles are tight, weak, or when there is a sudden increase in the level of activity. 

This condition may cause swelling and severe pain on top of the foot. It can be treated by resting, applying ice, taking medications, and using an ankle or foot brace. Sometimes, surgery may be required. 

2. Extensor Tendonitis

Extensor tendonitis occurs when the tendons on top of the foot are inflamed or irritated. Gradual bruising and swelling on the area may also be noticed. It can occur due to wearing very tight shoes, tight calf, standing or being on foot for long periods, when foot biomechanics are altered, when a heavy object is dropped on the foot, or when running or walking on uneven surfaces. 

This condition can be treated by resting, applying ice on the foot, injections, or employing ultrasound. The calf muscles can also be stretched. The way you lace your shoes should be changed along with using orthotics.

3. Sinus Tarsi Syndrome

In this foot problem, localized pain is often experienced on top of the foot and on the lateral side of the ankle. There is a small channel called sinus tarsi, which is found between the bone of the ankle and the heel. This condition occurs when the sinus tarsi is inflamed due to ankle sprains, repetitive activities, and poor foot biomechanics. 

Activity worsens the pain but it becomes better with proper rest. This condition can be treated by applying ice, doing stability training, joint mobilization, and exercises. Vigorous exercises should be stopped and complete rest should be taken for a faster recovery.

4. Hammer, Claw, and Mallet Toe

All these conditions are caused by toe joint deformities. A foot may have a strange shape because the ligaments, tendons, and muscles around the toe are not balanced, causing the toe to bend in an unusual position. 

These deformities also come as a person gets older, approximately affecting 10-15 percent of the population. However, women are more likely to develop these toe deformities than men, particularly those who regularly wear high heels or ill-fitting, tight shoes. The toes may also hurt due to the deformities. Other problems that occur with these conditions are long-term toe stiffness, calluses, or corns. 

These conditions can be treated by toe stretchers, exercises, injections, or surgery.

5. Gout 

This disorder usually causes pain in the joint of the big toe. High levels of uric acid cause formations of crystals in the joints, which causes gout in the foot. These crystals are often formed around the big toe. The chances of developing gout due to certain medical conditions, such as diabetes, is higher. Other risk factors include genetics, diet, and obesity. 

This condition causes redness, tenderness, heat, swelling, and a sudden intense pain. The symptoms tend to improve within a couple of weeks. It can be treated by medications, steroids, and an ice pack application.

6. Nerve Problems

Pain on top of the foot may also be due to nerve problems. Although it is more common for joint and tendon problems to cause foot pain, nerve irritation or damage may also be the culprit. Symptoms of burning, stabbing, or shooting pain are commonly experienced when there is nerve damage or irritation. Some examples of nerve problems that can cause pain on top of the foot are:

  • Diabetic Peripheral Neuropathy - This nerve problem is associated with diabetes and is characterized by a shooting or burning pain in the feet. 
  • Pinched Nerve - This condition is usually caused by excessive pressure from tight shoes, pressure from swelling, or blunt trauma. 

7. Bone Spurs

A toe spur may lead to pain, although not all bone spurs in the foot cause symptoms. When pain is experienced, it is usually due to the pressure of wearing shoes or friction against any type of surface. Its symptoms usually start as soreness or aching on any of the toes or on top of the midfoot. 

Diagnosis

If the pain on your foot persists for more than a week in spite of using home remedies, it's time to see a doctor. Seek immediate medical help if you have severe pain, which prevents you from walking or standing, and if you have tingling, numbness, or burning pain on one or both feet. Depending on your condition, a general practitioner may also refer you to a podiatrist. The doctor will examine your affected foot and may ask questions, including asking you to perform certain exercises, such as foot rolling to check your range of motion. The doctor may also ask regarding your other symptoms and the potential causes of your foot pain or injury, such as a history of ankle or foot injuries including your daily physical activities. 

If the doctor suspects a fracture, bone spur, or broken bone, a foot X-ray will be ordered. Other tests may include an MRI to check for peroneal nerve damage and blood tests to identify certain medical conditions, such as gout. 

Treatment

Seeking immediate treatment for any foot injury is very important since the feet are the ones that support an entire person's body weight. If a mild foot injury is left untreated, it could develop into a more extensive problem. Depending on the underlying cause of foot pain, treatment may include:

  • Home remedies
  • Using over-the-counter anti-inflammatory medications, such as NSAIDs to help reduce inflammation and gout symptoms 
  • A cast or medical walking boots for fractures or broken bones
  • Physical therapy