7 Most Common Conditions Causing Top of Foot Pain
By Dr. Rion Berg
July 13, 2020
Category: foot conditions
Tags: top of foot pain  

women with top of foot pain on top of toesWhen we experience top of foot pain or pain in other parts of our feet, instead of pushing through it we need to stop and pay attention since pain is a clue something's not right.

Pain on the top of our feet can come from our bones, tendons, or joints. It can be a sign of injury or an underlying condition.

Here are the seven most common conditions causing top of foot pain.

Stress fractures

Stress fractures are tiny, hairline cracks in the bone caused by repetitive force on the feet and ankles or rapid increase in activity. They are more likely to develop in people with faulty foot mechanics such as flat feet or in women athletes who are low weight or post-menopausal.

Ignoring this top of foot pain can lead to a complete break in the foot. In addition to pain, people can experience swelling, redness, and bruising on the top of their feet. Treatment includes rest and immobilizing the foot. In addition, the MLS laser can accelerate healing.

Patients with faulty foot mechanics can help prevent a reoccurence of stress fractures by wearing custom orthotics.

Hammertoe, Claw, or Mallet Toes

Pain on top of the toes can be a sign of hammertoe, claw toe, or mallet toe. While slightly different, all three of these conditions are a result of a muscle and ligament imbalance around the middle or end toe joints. This imbalance causes the toe to have a clawed or hammer-like look about it. The top of the joint sticks up causing it to rub against shoes causing pain.

People with these conditions often inherit them, but they can also be caused by trauma, arthritis, and can worsen as a result of wearing tight shoes such as heels with a tight toe box. These conditions are progressive.

In addition to pain where the toe joint meet the shoe, patients can also experience pain in the ball of the foot at the base of the hammertoe, corns and calluses as a result of friction, inflammation, redness, burning sensations, swelling, and on some occasions open sores.

Conservative treatment can include orthotics, toe separators and splinting to realign toes, injections, padding to prevent rubbing, injections, and oral medication.

Surgery is usually required once the condition has progressed from flexible to rigid.

Bone Spurs

A bone spur growing out of a joint at the top of your foot is called a dorsal or tarsal boss. While most bone spurs are painless, when they occur in a location that causes friction or irritation with shoes they can be problematic. They're caused by excessive pressure on the bone during sports, by wearing poor fitting shoes, or through trauma and form as a result of the body trying to repair itself.

Treatment for top of foot pain caused by bone spurs primary involves reducing the irritation by wearing shoes to accommodate it and by trying alternative lacing methods to reduce the pressure. Anti-inflammatory medication, cortisone injections, and MLS laser treatments may also be helpful in pain reduction.

Lisfranc Injury

The Lisfranc ligament is a tough band of tissue that connects the metatarsal bones that lead to the toes to the tarsal bones in the middle of the top of the foot. A Lisfranc injury can occur through direct and indirect force to that area of the foot, such as a heavy object hitting the foot or a fall where the foot gets twisted. This type of injury occurs most frequently in runners, horseback riders, and football players.

Symptoms can include swelling, pain throughout the midfoot when standing or with pressure, bruising or blistering on the arch, and an inability to bear weight when this injury is severe.

To determine the extent of a Lisfranc injury, imaging will need to be done. Tearing of the tissues and ligaments are of most concern. Depending on the injury, treatment can involve immobilization of the foot, ice and elevation, and physical therapy.

Ganglion cyst

Ganglion cysts are soft, fluid-filled, benign (non-cancerous) lumps connected to tendons and joints and are often found on the top of the foot. Most cysts cause mild pain as a result of the pressure created by wearing shoes. However, when they enclose or press on a nerve, the pain can be intense.

The best way to prevent cysts from forming is to wear well-fitted, comfortable shoes and avoid repeated foot injuries. Ganglion cysts can be drained or injected with steroids but often come back. Surgical removal is an option to prevent reoccurence.

Hallux rigidus

Have you developed pain on the top of your big toe joint? You most likely have a form of degenerative arthritis called Hallux rigidus. As stated in the name, the toe becomes increasingly rigid as the condition worsens. An earlier stage of this condition is called Hallus limitus, as the movement of the toe is somewhat limited but not completely frozen as it can with its cousin. Hallux rigidus has several causes. It can develop as a result of overuse or injury from athletics or stubbing of the toe, an inherited foot type such as overpronation, or from an inflammatory disease condition such as rheumatoid arthritis or gout.

Besides experiencing pain upon walking, symptoms can include a bump on the top of the foot and swelling around the joint. In the early stages of Hallux rigidus, custom orthotics and rocker style shoes are used to control the motion and pain associated with this condition. It later stages when damage is more severe surgery is necessary.

Extensor tendonitis

Extensor tendonitis is a form of tendonitis that develops on the top of the foot where your tendons attach to your toes. It results from overuse or wearing shoes that are too tight during physical activity. Running uphill and downhill can be particularly problematic in the development of this condition. It is also commonly found in dancers, skiiers, and figure skaters.

Rest, applying ice, and anti-inflammatory medication can all help in reducing the inflammation from tendonitis. If foot imbalances are part of the reason for the tendonitis, orthotics can also help prevent it.

Call us today at 206-368-7000 for an appointment. Often same day for emergencies and less than 2 weeks for chronic foot pain. You can also request an appointment online.

For more information about foot and ankle problems, download our eBook, "No More Foot Pain".

In addition, our newsletter "Foot Sense" comes out monthly.  You can also check out our past issues. Every issue contains a mouth-watering recipe and can be printed out for easier reading!

Seattle foot and ankle specialist, Dr. Rion Berg offers foot care for patients with bunions, heel pain, diabetes, fungal toenails, ingrown nails, and surgical solutions when needed to residents of Seattle, Bellevue, Kirkland, Shoreline, Lake Forest Park, Mountlake Terrace, Lynnwood and other surrounding suburbs.

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