Pain On Top Of Foot – Causes And Treatments

There are several reasons for having pain on top of foot. The type of pain and the location of the pain are important in finding the cause of the pain and how to best treat it.  In this article, we delve into the various causes for pain on top of foot, and the various recommended treatments for each cause.  A lot of the research done for this article was based upon information we found at the NINDS or National Institute of Neurological Disorders and Stroke, a great source of information for just about anything medical.

Cause: Tarsal Coalition

One condition that can cause pain is called Tarsal Coalition. The pain is usually felt on the outside part of the topof the foot. It is caused by the the irregular fusion, or blending, of two or more bones in the mid portion of the foot. It can be hereditary. It tends to get worse with activity and if it is not treated it can cause major arthritis in the foot causing a restriction in the person’s activity. Early identification is made using x-rays and a MRI or CT scan. Treatment is with the use of well-designed orthopedic devices and sometimes surgery.

Cause: Stress fracture

Pain can also happen on the top and inside of the foot, especially in people who are very active in sports. The pain can be due to a stress fracture of one of the bones, particularly the Navicular bone, which is one of the tarsal bones. This bone is apt to be fractured by athletes while kicking, sprinting, twisting, or falling. Diagnosis can sometimes be tricky. X-rays are usually negative and if a stress fracture is there the identification may need a bone scan or MRI to be sure. Management is usually rest with a restriction of activity , anti-inflammatory prescriptions, a cast, orthopedic devices, or, hardly ever, surgery to examine the area.

Cause: Flat Feet

Flattening of the foot causes pain on the top of the foot just below the ankle joint on the outside portion of the top of the foot. In this part of the foot there is a small fleshy area.This fleshy area is a small muscle called the Extensor Digatorum Brevis which helps extend the toes. Underneath the muscle there is a small canal between two bones. This area is called the Sinus Tarsi. In this area there are three small ligaments that can become irritated and swollen. The flattening of the foot pinches these small ligaments. Sometimes there is actual overcrowding of two bones causing the pain. Stretching the calf muscles will help to lower the effect of flat feet. Anti-inflammatory medicine, cortisone injections, and orthopedic devices can help. Occasionally surgical examination is needed.

Cause: Sinus Tarsi Syndrome

Sinus tarsi syndrome comes from too much motion of the subtalar joint in the ankle. Athletes involved with jumping sports may acquire an injury to the subtalar joint after coming to an abrupt stop after a jump or a fall. Pain is felt in the top outside of the foot by the ankle. The recommended action is usually balance and proprioceptive training. A proprioceptor is a sensory receptor that detects motion or position by responding to stimuli. Treatment may also include muscle strengthening exercises, bracing, and taping.

Cause: Ganglion cysts

Ganglion cysts of the foot are benign, or not harmful. There may be a burning feeling or pain if the cyst is pressing on a nerve, joint, or tendon. These fluid-filled, soft-tissue masses join to tendon sheaths or joint capsules. The fluid tends to be thick, sticky, clear, and jelly-like. It is similar to synovial fluid, which lubricates the joints and tendons. The term ganglion means “knot,” which is how these might be described. They may develop quickly or over a period of years, being cause by either trauma or continual overuse. They may shrink, enlarge, appear and disappear. Most of them go away within two years. Management of the ganglion depends on the symptoms. The simplest form of treatment is aspiration (or drainage) of the ganglion. Usually the area is numbed with local anesthetic, after which a large-gauge needle is used to remove the fluid. Often a corticosteroid, and sometimes a dissolving enzyme, is injected after the drainage to lower the likelihood of recurrence. If the aspiration technique does not work, surgery may be done to remove the cyst. It involves local anesthesia, sutures, bandaging, and possibly splinting, depending on the size and location of the cyst. The benefit of the excision process is that it has a considerably higher success rate in preventing reappearance.


These are just some of the causes of pain on top of the foot. A person experiencing pain that does not go away in a short period of time should see a doctor for diagnosis and treatment.

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