Top of foot pain is simultaneously frustrating and confounding. It’s such an odd location for an injury that it may seem nonsensical, but there are plenty of reasonable causes behind those aggravating aches.
We’ve put together a list of the six most common causes of foot pain—top of foot pain, to be exact. Along with each cause, you’ll find a section on how to remedy the problem, either at home or with the help of a medical professional.
Read on to learn about what might be causing that pesky pain in your foot and gather some well-informed advice about the next step forward.
Tendinitis is a condition caused by inflammation of the tendons.
Tendons are the connective tissue that attaches your muscles to the bones. Tendinitis itself has many causes, though the most typical one is over-exertion from repeated movement.1 For instance, a baseball pitcher could develop tendinitis in the tops of their feet after drilling the same pitch all practice.
A few other possible causes of tendinitis are:
- Certain diseases of the kidneys and blood
- Side effects from certain medications
- Compensatory pain
When experiencing tendinitis, one can often feel a dull ache or tightness in the affected area. Professional diagnosis requires an evaluation, a physical examination, a range of motion test, and sometimes medical imaging like an X-ray or an MRI.
At-home tendinitis management will sound familiar if you’ve ever dealt with a sports injury. Most cases can be treated with rest, the elevation of the affected limb, and careful stretching once movement is no longer painful.
A compression bandage, over-the-counter pain medications or anti-inflammatories, and heat or ice may help manage pain on top of foot as well as swelling.
More severe or chronic cases of tendinitis may require professional intervention. There are various treatments a doctor might recommend, from steroid shots to physical therapy—or, in extreme cases, surgery.1
#2 Stress Fracture
Your feet and ankles are home to twenty-six individual bones. Five of them in each foot are known as metatarsals. The metatarsals run along the top of your feet, connecting your ankles to your toes.3
The metatarsals are a common location for stress fractures, particularly in women. Stress fractures, similar to tendinitis, typically occur because of over-exertion of a body part. Your foot pain may be related to a stress fracture of the (any of bones can have stress fractures, not just metatarsals) metatarsals if:
- You participate regularly in strenuous, high impact activities involving the feet and ankles, like running or jumping
- You’ve recently increased the intensity or frequency of your exercise routine
- You have a condition such as arthritis, osteopenia or osteoporosis
- You have pre-existing nerve damage, called neuropathy
- Your top-of-foot pain worsens with exercise or even normal activities such as walking
Stress fractures develop over time. If you’re feeling pain that reminds you of a deep bruise, it may be a developing stress fracture called a stress reaction.
Stress Fracture Remedies
If you suspect that you may have a stress fracture or stress reaction, you should see a doctor for an official diagnosis and treatment plan. While you’re waiting for your appointment, make sure to keep your weight off the foot that’s hurting, avoid walking barefoot and elevate it when possible.
Be especially careful to abstain from the activity that you suspect may have caused the fracture.
Your doctor will conduct a physical examination and an evaluation. Plus, they’ll probably order some imaging as well. If it turns out that a stress fracture is the reason behind your symptoms, here’s what you may be able to expect moving forward:4
- Complete recovery will require up to eight weeks of rest and immobilization.
- Your doctor may fit you with a cast, a boot, or a rigid-soled shoe to help you keep your foot in the correct position and limit motion.
- You may receive a prescription for anti-inflammatories or painkillers.
- Physician-approved physical therapy involving low-impact exercise and cross-training is a possible avenue if you’re itching to get moving.
#3 Bone Spurs
Bone spurs are painful, bony growths that form along the edges of bones. They tend to occur frequently in and around joints, like the joints between the metatarsals and the toes.5
Most of the time, bone spurs don’t cause any symptoms. When symptoms do occur, it’s best to get checked out by a doctor. Left untreated, severe bone spurs can end up causing long-term mobility problems and are often associated with other conditions like arthritis.3
Pain, tenderness, and swelling are the most common physical symptoms of bone spurs.
Bone Spur Remedies
For the most part, pain from bone spurs can be addressed at home with over-the-counter medications, the application of ice, and quality rest. Specially designed shoes, can help cushion and support your feet, relieving pressure and stress associated with bone spurs.3
If home remedies don’t bring relief, a medical practitioner can recommend further treatment. Physical therapy, steroid shots, prescription pain medicine, and surgery are all options for the rare chronic case of bone spurs.
Bone spurs that occur on the top of the midfoot are common and can be easily irritated by shoes and also laces. Choose styles that avoid this delicate area if you have a bone spur that is causing irritation and pain. Also, try relacing the laces to avoid the “criss cross” right at the site. This will alleviate some pressure, friction and rubbing at the area.
Gout is an arthrophy which is caused by a buildup of uric acid in the blood. It can later cause gouty arthritis. The effects of gout are chiefly felt in the feet, and most commonly affected is the great toe joint. Uric acid crystals become trapped in the joints, resulting in attacks of gout. When left untreated, these crystal structures may solidify into “tophi”, causing pain and permanent damage to the affected joints.
Pain in the top of the foot can sometimes be caused by gout. Here are some other associated symptoms to look out for:6
- Acute pain in the joints, particularly the joints in the big toe (pain tends to be most intense for the first 5-10 hours of the attack)
- Redness, hot to the touch, and swelling
- Difficulty moving
- Persisting discomfort after the initial onset of pain has ended
- Attacks that escalate in frequency, intensity, and amount of joints affected
If you suspect you may be suffering from gout, get in touch with your doctor as soon as you can. It’s a treatable condition, but it’s safest to address it early on. Early intervention and treatment with medications that reduce the amount of uric acid in the blood can circumvent the effects of gout.7
Some medications for other comorbidities can also precipitate gout attacks, such as blood pressure medications. Your doctor may treat you with short term oral or injectable anti inflammatories and may also need to prescribe a more long term treatment, in more severe cases, to prevent future flair ups.
Doctors typically recommend lifestyle changes along with treatment for gout. Losing any extra weight, changing your diet, avoiding gout triggering foods, staying hydrated and reducing your use of alcohol and cigarettes could greatly assist in treating and preventing gout attacks.
Arthritis, a condition where bones and their surrounding cartilage suffer painful damage, thinning and inflammation, has several causes, symptoms, and possible locations in the body. Pain and stiffness in the joints of the feet are frequently related to arthritis.
The three most common types of arthritis found in the feet are:8
- Rheumatoid arthritis – Both feet tend to be equally affected by this autoimmunerelated manifestation of arthritis.
- Osteoarthritis – Cartilage between bones eventually wears down due to age and repeated movement. Osteoarthritis will present differently depending upon the individual.
- Trauma-related arthritis – Arthritis can develop due to damaged cartilage from an injury.
Since the umbrella of arthritis can cover a wide range of diseases and underlying causes, there are also many ways to treat it. Here’s how arthritis-related pain in the foot can be addressed:9
- Pain and inflammation can be managed with over-the-counter anti-inflammatories.
- A therapist could help exercise and stretching routines to the affected areas to keep the body as limber as possible, build strength and resiliency.
- A doctor may prescribe corticosteroid injections to affected joints.
- Orthotic aids like insoles and comfortable shoes reduce severe pain and support movement.
If arthritis is too advanced for gentle, at-home therapies, there are a variety of surgeries that can help. From surgical removal of spurs to the fusion of bones, and joint replacement surgeries. Modern medical science has more than risen to the challenge of treating arthritis.
#6 Ganglion Cyst
Ganglion cysts are benign lumps usually located around joints and tendons. They can be so small that they’re impossible to notice or grow to be the size of a ping-pong ball.
Science is still unsure about the exact cause of ganglion cysts. They may be related to arthritis or come about due to an injury or oxer-exertion.
Typically a ganglion cyst will resolve itself without treatment. However, when they’re located on the top of the foot, they can cause sharp pain and discomfort that may need addressing.6
Ganglion Cyst Remedies
Most ganglion cysts go away on their own. Even so, if you have a persistent, painful lump, make an appointment to get it checked out, just in case. A doctor can lance and drain a ganglion cyst that’s causing you discomfort.
Get Ahead of Foot Pain With Vionic
Don’t keep wearing shoes that put you in pain, and relace laces to avoid the “criss cross” to lay just over the cyst. Top of foot pain can be exacerbated and even partially caused by ill-fitted, poorly-designed footwear.
Vionic’s science-backed orthotic shoes can help you find relief from foot pain, one pair at a time. Our Vio-Motion™ footbed technology was developed by the experts at the Vionic Innovation Lab, a team of podiatric professionals. In fact, many of our shoes carry the American Podiatric Medical Association’s Seal of Acceptance. Some of our footwear lines include performance shoes, orthopedic sandals for men, and possibly the most comfortable dress shoes for women. So you can find a shoe that can alleviate your foot problems.
The best news of all? Vionic shoes are just as stylish as they are supportive. Browse our selection of walking sandals to find the perfect fair-weather pair and shop for all seasons. Walk the path to pain-free mobility in a pair of posh Vionic shoes.
Dr. Jacqueline Sutera is a surgically trained doctor of podiatric medicine specializing in the prevention and treatment of foot pathology. She graduated from Fordham University with a Bachelor of Science degree in Biology and Philosophy. She later attended the New York College of Podiatric Medicine where she earned the degree of Doctor of Podiatric Medicine (DPM).
Dr. Sutera received her postgraduate residency training at the busy level-one trauma center at Jamaica Hospital in Queens, NY and Brookdale Hospital in Brooklyn, NY. During her time there, she served as chief surgical resident and received and completed training in all aspects of podiatric medicine and surgery. Dr. Sutera is Board Certified in Foot Surgery and is a Fellow of the American College of Foot & Ankle Surgeons.
She is also a proud member and spokesperson for the American Podiatric Medical Association and the New York State Podiatric Medical Society. As one of NYC’s premier podiatric physicians, she is a caring, conscientious and extremely personable doctor who prides herself on being holistic in her approach to foot care. Where other doctors treat feet only locally, she has a unique gift of being able to link some foot problems to other underlying conditions taking place in the body.
- Pietrangelo, Ann. “What Is Tendinitis?” Healthline. 29 September, 2021. https://www.healthline.com/health/tendinitis
- “Tendinitis.” Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/10919-tendinitis
- “Stress Fractures.” Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/15841-stress-fractures
- “Metatarsal stress fractures – aftercare.” Medline Plus. https://medlineplus.gov/ency/patientinstructions/000553.htm
- “Bone spurs.” Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/bone-spurs/symptoms-causes/syc-20370212#:~:text=Bone%20spurs%20are%20bony%20projections,joint%20damage%20associated%20with%20osteoarthritis.
- Ericksonn Gabbey, Amber. “Ganglion Cysts.” Healthline. Updated 24 January, 2022. https://www.healthline.com/health/ganglion-cysts#prevention
- Watson, Stephanie. “Gout: Symptoms, Causes, and Treatments.” Healthline. Updated 23 September, 2021. https://www.healthline.com/health/gout
- “Types of Foot & Ankle Arthritis.” NYU Langone Health. https://nyulangone.org/conditions/foot-ankle-arthritis-in-adults/types
- “Foot and Ankle Arthritis.” Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/13900-foot-and-ankle-arthritis