Pain on the top of the foot is a common problem. Every step we take places a force of 1.5x body weight through our feet so it’s no wonder our feet get sore!

Most cases of pain on top of the foot’s are due to either an injury, overuse, wear, and tear, or even ill-fitting footwear. Pain may be due to a problem in the bones, soft tissues, or various medical conditions. There may even be a top of-the foot lump.

We are going to look at the common causes of pain on top of the foot’s, how they present, and the best ways to treat them.

A stress fracture is a common cause of pain on top of the foot caused by a small break in one of the foot bones e.g. metatarsal fracture

Stress fractures cause moderate to severe pain, swelling, and tenderness over the fracture site.

Most stress fractures are the result of repetitive overloading e.g. kicking, running, jumping, or suddenly increasing training levels.

You can find out all about the different causes, symptoms, and treatment options in the Foot Stress Fractures section.

Sinus tarsi syndrome is a common cause of ongoing pain on the top of the foot after an ankle sprain. With sinus tarsi syndrome there is inflammation of the small, bony channel between the heel & ankle.

Common symptoms include ankle stiffness, instability, and pain on the outer side of the top of the foot when walking or standing.

Sinus tarsi syndrome most often develops after an ankle sprain but may also be due to prolonged instability and altered foot biomechanics

Find out all about the common causes, symptoms, diagnosis, and treatment options in the Sinus Tarsi Syndrome section.

There are three common toe deformities that cause top-of-foot pain by altering the positions of the small bones

The most common symptoms of these toe deformities are abnormal curling of one or more toes which may or may not be accompanied by stiffness and pain.

Toe deformities often develop from wearing tight, pointed shoes but may also be caused by a toe injury, problems in nerves or blood vessels, or arthritis

Find out all about these common toe deformities, how to tell which one you have and how to treat them Hammer, Mallet, Claw Toes section.

Extensor tendonitis is one of the most common causes of gradual onset pain on the top of the foot. With extensor tendonitis, there is inflammation of the tendons on the top of the foot that contract to lift the toes.

Extensor tendonitis usually causes a gradual increase in pain, swelling & tenderness over the top of the foot and there is often discomfort when wearing shoes due to pressure on the tendons

Tight shoes, flat feet, prolonged standing/walking, muscle tightness, and off-road running are common causes of extensor tendonitis.

You can find out all about this common cause of pain on top of the foot, including the causes, symptoms, and treatment options in the Extensor Tendonitis section.

Another possible cause of top foot pain is tibialis anterior tendonitis. This is where there is inflammation of the tendon at the front of the ankle that lifts up the foot.

Tibialis anterior tendonitis usually causes a gradual increase in pain on the top of the foot and at the front of the ankle which often feels worse after resting.

Common causes include overuse e.g. running, esp. off-road or downhill, and muscle weakness & tightness.

You can find out all about the common causes, symptoms, and treatment options in the Foot Tendonitis section.

1Gout is a type of inflammatory arthritis that causes crystals formation in joints e.g. big toe, due to high uric acid levels.

Gout foot causes a sudden onset of intense pain in the big toe and on top of the foot (typically at night), redness, heat, and swelling in the foot.

You are more at risk of developing foot gout if you have a purine-rich diet (lots of red meat), have a family history of gout, are overweight, or have diabetes.

Find out all about the causes and symptoms of gout and how to treat and prevent it in the Gout Foot section.

One of the less common causes of pain on top of the foot is athlete’s Foot, a fungal infection of the skin. Also known as tinea pedis it affects approximately 15% of the world’s population.

Athletes’ foot results in scaly, itchy, flaking skin, swelling, and blistering which can cause pain on top of the foot.

It normally develops due to poor foot hygiene, excess moisture, and humid conditions and is highly contagious.

You can find out all about the causes, symptoms, and treatment options in the Foot Rashes section.

Pain on top of the foot that is accompanied by altered sensation is often due to pinching or compression of a nerve in the foot, leg, or lower back.

There may be burning or shooting pain along the top of the foot, pins, and needles, numbness, and/or foot weakness

Nerve injuries usually originate from swelling, injury, spinal deformity, or disc bulge in the lower back. There is often no actual pain in the back itself, the symptoms may only be felt in the foot.

Find out all about the causes, symptoms, diagnosis, and treatment options in the Nerve Pain In Foot section.

Pain on the top of the foot that is accompanied by a lump is often due to a ganglion.

Ganglion cysts are small lumps filled with jelly-like fluid often found near the foot joints & tendons.

They are small, pea-like nodules that can cause pain if they press on nearby structures in the foot, particularly nerves.

Often there is no obvious reason why ganglion cysts develop but they are more common after a foot injury or as we age.

Tarsal coalition is a rare cause of pain on top of the foot affecting only around 1% of the population.

With a tarsal coalition, a bony bridge forms between two or more of the foot bones. This leads to stiffness, instability, and foot pain, typically in early adolescence.

Tarsal coalition is a congenital condition (present since birth) and is often hereditary.

Find out all about the common causes, symptoms, and treatment options in the Tarsal Coalition section.