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Top of Foot Pain

Dr. Joseph DAmico

Reviewed by
Dr. Joseph DAmico

Pain on the top of the foot can make it difficult to walk, run, or stand. Top-of-foot pain can be mild or severe, intermittent or chronic. Did you know the average person stands for five hours a day and takes up to 10,000 steps? That is a lot of stress to place on the feet. Our feet are complex structures built to absorb the shock of each step, but overuse, medical conditions, and injuries can all lead to pain on top of the foot.

Each foot comprises twenty-six bones and thirty-three joints, bound together by more than 100 muscles, ligaments, and nerves. Our feet support our weight, act as shock absorbers, propel our legs forward, and help us keep our balance on uneven surfaces. With such important and constant duties to perform, our feet are susceptible to pain.

Top of Foot Pain Symptoms

The pain itself may be all you experience, but additional symptoms may be present depending on the cause of the problem. These may include:

  • Warmth at pain site
  • Tenderness of the foot
  • Redness
  • Swelling
  • Pain that worsens when walking or standing and decreases when resting
  • Difficulty walking and standing

What Causes Top of Foot Pain?

There could be various reasons why you are experiencing pain on the top of your foot. Common causes of this include:

Top of Foot Pain

Stress fractures are a common cause of pain on top of the foot. Metatarsal fractures are also a common cause. Fractures can be caused by repetitive movements, weak muscles, improper alignment of the bones in the lower extremity, arthritis, reduced bone density, and injury or trauma. Diseases such as gout, diabetes, tendonitis, and arthritis also lead to top-of-foot pain. Occasionally the nerves become traumatized when pressure is applied to them. A tight pair of shoes can cause pressure. Hormonal imbalances, such as occur during pregnancy or menopause, can also cause the top of the foot to ache. As we age, many parts of our body begin to weaken, especially our feet. Using your feet excessively throughout your life can lead to pain on the top of the foot when you are older.

When to See Your Doctor

If you are experiencing pain on top of your foot, you should consider seeing your doctor as soon as possible. Pain in this location is not normal, and usually indicates a more serious problem. Catching conditions and injuries such as stress fractures in their early stages is vital to successful treatment. Diagnosing problems within the complex structure of the foot is difficult enough, but if a condition or injury is left untreated, it can develop into a more serious problem and could require more extensive treatment.

Diagnosing Foot Pain

If you are experiencing pain on the top of your foot, you should take it seriously and contact a podiatrist or your primary doctor. Your doctor will perform a physical and visual exam with weight-bearing and non-weight bearing movements. He or she will also ask you about your activities leading up to the pain, as well as your medical history. Muscles, nerves, tendons, bones, and ligaments will also be examined with x-rays, MRIs, and bone scans to rule out specific conditions or injuries. Your doctor may also want to take a look at your shoes to ensure that they fit properly and to note abnormal wear patterns.

Top of Foot Pain Treatment

There are several things you can do to treat the pain on top of your foot. Seeing a podiatrist or foot specialist should be your first step. Treatment for your top-of-foot pain will be based on the cause and the severity of the pain. Foot doctors often use the RICE method to relieve foot pain. RICE stands for: Rest, Ice (applied for twenty minutes at a time), Compression, and Elevation. These are the four basic elements used to treat any kind of injury to the foot. Other treatment options may include:

  • Over-the-counter medication (Tylenol, aspirin, ibuprofen and naproxen) to reduce pain and discomfort.
  • Shoe inserts or other types of orthotics 
  • Medications prescribed for more severe symptoms
  • Stretching the foot muscles
  • Switching foot wear
  • Strappings and/or paddings
  • Limiting activities
  • Surgery (for severe cases)

Crutches may be necessary to allow your foot to rest during the healing process. If a fracture is present, recovery may take four to six weeks. If the pain is caused by improper footwear, the problem may be solved as soon as new, proper-fitting footwear is purchased. Your doctor will create an appropriate treatment plan based on the underlying cause of the pain. This may include the options listed above.

Talking to Your Doctor

Here are some questions you may want to ask your doctor if you are experiencing top-of-foot pain:

  • Once treatment is given, how long will the pain last?
  • What will happen if I do not address this problem?
  • What are the chances this pain will continue?
  • Is there an underlying cause for this problem that also needs to be addressed in order to prevent a recurrence?
  • What changes, if any, do I need to make in my diet?
  • Will plantar fasciitis exercises help relieve the pain?
  • If the pain continues, how long should I wait before coming back?
  • If I have to come back, what diagnostic tests should I expect?
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Medical References:

  1. Top of Foot Pain, Causes and Treatment, http://www.topoffootpain.org
  2. American Academy of Orthopaedic Surgeons, Stress Fractures of the Foot and Ankle, http://orthoinfo.aaos.org/topic.cfm?topic=a00379
  3. M. Beers "Merck Manual of Medical Information" 2nd home edition (Pocket Books, 2003) 354; 422-423

This page was last updated on December 17th, 2014



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