Pain on the top of the foot often occurs due to overexertion or injury. However, several chronic conditions can also cause pain in the top of the foot.

The foot has a complex set of tendons, muscles, joints, and bones that enable it to work properly. Disruption of any of these parts can cause pain throughout the foot.

Taking note of the pain and symptoms and what came before the problem can help determine the cause. This ensures that the correct treatment can be given.

This article covers common causes of pain in the top of the foot and what treatments are available.

An injury, such as a sprain or bone break, can occur in any part of the foot, including the top.

Problems with the top of the foot can be due to dropping something on the area. There can be other, less obvious causes, however.

Lisfranc or midfoot injury

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Bianca Loðbrók/Stocksy United

The middle of the foot is known as the Lisfranc area or midfoot. This area comprises a group of small bones and tendons that help form the foot’s arch.

Injuries to the midfoot can cause pain and swelling on the top of the foot, which may worsen when standing or walking.

Midfoot injuries can occur due to:

  • impact injuries
  • overextension of the midfoot
  • overuse

Fracture of fifth metatarsal

Pain on the outer side of the top of the foot is often related to the fifth metatarsal. This is a long bone that connects the little toe to the middle of the foot.

Several types of fractures may occur in the fifth metatarsal:

  • Avulsion fracture: This occurs when a tendon or ligament pulls a small piece of the fifth metatarsal out of place. An avulsion fracture often occurs with an “ankle roll” injury and may happen along with an ankle sprain.
  • Jones fracture: This type of break often occurs near the top of the fifth metatarsal, close to the outside and middle area of the foot. It can be a small hairline fracture caused by repeated stress and strain on the foot, or it can be a more severe break due to an injury or fall.
  • Midshaft fracture: This type of break is often due to an accident or twisting of the foot. It occurs near the middle of the fifth metatarsal.

Extensor tendinitis

Tendinitis can occur in many different areas of the feet and legs. The extensor tendons on, the top of the foot, are needed for flexing or pulling the foot upward.

Excessive flexion or walking in shoes without proper support can damage these tendons. This is known as extensor tendinitis, which can cause significant pain in the top of the foot.

Extensor tendinitis pain usually worsens with activity such as walking or running and may also occur alongside swelling of the top of the foot. It may come about after excessive or too much exercise too soon.

Ganglion cyst

A ganglion cyst forms below the skin’s surface, appearing like a bump or sac filled with fluid.

It often forms on top of the foot and may happen after an injury to the area. The cause of these cysts, however, is not always clear.

A ganglion cyst can cause pain if it is pressing against a muscle or joint in the foot. It may also cause tingling or burning if it is located near a nerve. If the cyst is large, it can cause discomfort or pain when it rubs against shoes.

Not all foot pain is related to an injury or overuse. Some health conditions can cause foot pain, especially those affecting nerves and joints. Some examples include:

  • Arthritis: The metatarsophalangeal joint (MCP) is located at the base of each toe and can cause pain on top of the foot if it is affected by arthritis.
  • Diabetes: Diabetes can cause nerve damage, particularly in the feet. Uncontrolled diabetes can lead to tingling, numbness, and pain in any part of the foot.
  • Gout: Gout is a disorder that causes a painful buildup of uric acid in the joints. Although gout most commonly affects the big toe, it can affect the top of the foot and other areas of the body.

Because pain on top of the foot can be a sign of many different issues, diagnosis usually involves a doctor taking a person’s medical history, as well as medical tests.

Diagnosis may include a physical exam of the foot, X-rays, MRI, or other imaging scans. Testing for diabetes, gout, and other diseases may also be required.

Treatment will depend on the underlying cause of the pain.

Foot pain cannot always be prevented, but practicing good foot care can help. People should aim to do the following:

  • Ease into exercise: Many foot injuries occur when a person does too much, too soon. Exercise should gradually increase in time and difficulty.
  • Warm-up and cool down when exercising: Stretch muscles in the feet and calves gently once muscles are warm.
  • Rest the feet: Muscles and joints can benefit from a day off, especially for those who do a lot of running, sports, or high impact activities.
  • Wear supportive shoes: This is especially important for people with diabetes or arthritis. Shoes that fit properly and provide support can help prevent pain from overuse, sprains, and strains.

People should also avoid going barefoot and replace shoes when they begin to look worn or become uncomfortable.

The feet are complex structures or bones, joints, muscles, and tendons. Damage to any of these components can cause pain, swelling, and mobility difficulties. Impact injuries are a common cause of pain in the top of the foot, but overexertion, flexion, and some underlying health conditions can also cause pain in the top of the foot.

Treatment for these pains will depend on the root cause.