The Most Common Top of the Foot Pain Causes

A common symptom is pain at the top of the foot, which can make it difficult to walk or take part in other activities.

Pain at the top of the foot, while it may start out moderate, can become persistent and disabling if not treated.

The key to getting a proper diagnosis and some relief is knowing the possible causes. This article will give you an in-depth look at the most typical causes of discomfort in the ball of your foot.

Extensor Tendonitis

Inflammation of a tendon occurs when a tendon, which attaches a muscle to a bone, becomes inflamed. The extensor tendons, which cross the top of the foot and lift the toes, are the ones most commonly affected by extensor tendonitis.

Overuse, high-impact activity, repetitive motion, poor foot mechanics, and wearing shoes that don’t fit can all aggravate these tendons. Pain over the tendon is the primary complaint, and this pain increases with movement and decreases with rest.

There may be swelling, pain, and crepitus (a cracking sound) when the tendon is manipulated. Rest, ice, anti-inflammatory drugs, altered footwear, physiotherapy, and even steroid injections may all be part of the treatment plan.

Stress Fractures

Tiny fissures in the bone called stress fractures result from repeated overuse and impact. Forefoot metatarsal fractures are common because these bones take so much pressure during walking, running, and jumping.

Weight-bearing exercise can bring on excruciating, throbbing pain in the ball of the foot if you have a stress fracture of the second, third, or fourth metatarsal.

Initially, pain relief from rest is common, but the fracture will likely worsen the more time passes. There is a chance of swelling and bruising as well. Imaging tests including x-rays, CT scans, and MRI are needed for a firm diagnosis.

In addition to pain medication, treatment requires wearing a cast or walking boot for 6-8 weeks.

Arthritis

Arthritis causes swelling and eventual degeneration of the joints. The joints at the top of the foot are vulnerable to the most prevalent form of arthritis, osteoarthritis.

The joints in the midfoot, such as the tarsometatarsal ones, and the MTP joints at the tips of the toes are included. Damaged cartilage in the high points of the foot leads to discomfort, inflexibility, edema, and pain.

Pain can be managed with nonsteroidal anti-inflammatory drugs (NSAIDs), shoe inserts, and physical therapy. Extreme instances may require surgical intervention or steroid injections. Pain at the top of the foot can also be caused by inflammatory arthritis such as rheumatoid or gout.

Morton’s Neuroma

Inflammation of a nerve in the ball of the foot, which runs between the metatarsal bones, is the root cause of this frequent foot ailment.

Compression of the nerve and resulting discomfort in the ball of the foot can be caused by high heels, tight shoes, high-impact activity, and improper foot biomechanics.

The sense of a rock or lump in the shoe, burning or tingling in the toes, and other similar sensations are all symptoms. Walking and weight bearing are painful.

Shoe adjustments, orthotic inserts, cortisone injections, and, in extreme situations, surgical removal are also potential treatments.

Metatarsalgia

Pain and swelling in the ball of the foot is called metatarsalgia. It’s caused by putting too much weight on the metatarsal heads, which can happen when wearing high heels or shoes without enough padding.

Forefoot pain that is exacerbated by standing and walking, as well as intense, shooting pain in the toes and calluses under the metatarsal heads, are other symptoms.

Offloading pressure and reducing pain can be achieved through icing, orthotics, shoe changes, taping, and physical therapy. If non-invasive treatments are ineffective, surgery may be considered.

Capsulitis

Inflammation and thickening of the ligaments around the metatarsophalangeal joints lead to this disorder. Walking and other daily activities can cause discomfort, edema, and stiffness in the MTP joints of the top of the foot.

The population most at risk consists of middle-aged women. Capsulitis sufferers may feel throbbing or aching even when at rest, in addition to the pain experienced when bearing weight.

When noninvasive treatments like steroid injections, orthotics, nonsteroidal anti-inflammatory drugs (NSAIDs), and physical therapy aren’t effective, surgery may be suggested.

Lisfranc Injury

The midfoot and the forefoot are joined by the Lisfranc joint complex. Foot instability and bone misalignment can result from injuries to this area, which commonly occur from falls, trips, and stumbles, or crushing trauma.

Pain, swelling, and bruises on the top of the midfoot, as well as the inability to bear weight, result from this condition. A quick x-ray, CT scan, or MRI can tell you if your bones are broken or your ligaments are torn.

Immobilization and rest can help minor wounds heal. Surgery to straighten the joint and insert screws or plates is often necessary for patients with severe Lisfranc injury.

Foot Sprain

Sprained feet and ankles are very frequent, especially among athletes. When the ligaments on the top of the foot are suddenly overstretched or torn, the outcome is pain, discomfort, swelling, bruising, and a decreased range of motion.

When treated with rest, ice, compression, elevation, and taping, most sprains heal in two to four weeks. High ankle sprains that are particularly severe often call for a combination of rest in a walking boot and physical therapy.

Non-healing sprains should be evaluated by a doctor of orthopedics and scanned to rule out fracture or instability.

Peripheral Neuropathy

Nerve damage in the body’s periphery is the root cause of neuropathy. The most common reason is diabetes. Nutrient deficiencies, infections, tumors, autoimmune diseases, chemotherapy, and idiopathic factors also contribute to the development of neuropathy.

Symptoms typically begin in the toes and progress upward through the soles of the feet, including numbness, tingling, or searing pain. Symptoms are more severe at night.

Diabetic neuropathy can be slowed or stopped in its tracks with strict glycemic control. Neuropathy can be controlled with medication, orthotics, physical therapy, and even a change in diet and way of life.

Tarsal Tunnel Syndrome

Tibial nerve branches, tendons, and blood vessels are housed in the tarsal tunnel, which runs along the inside of the ankle. Foot abnormalities, arthritis, trauma, and lesions that take up too much space can all put pressure on or irritate the tibial nerve.

As a result, you may experience stabbing pain, burning, numbness, or tingling that radiates from the top of your foot all the way to your big toe and the toes surrounding it. The symptoms are more severe when I exercise or sleep.

You may get relief from nonsteroidal anti-inflammatory drugs (NSAIDs), physical therapy, orthotics, or corticosteroid injections. In severe circumstances, tunnel decompression surgery may be considered.

Ganglion Cysts

Ganglion cysts are soft, noncancerous lumps that commonly develop close to ligaments and tendons. Common sites of occurrence include the top of the foot, where they arise from the underlying joints or tendon sheaths.

Mild discomfort, numbness, or burning may be experienced on the top of the foot if a ganglion cyst is pressing on a nearby nerve. Painful cysts may be aspirated or surgically removed.

However, drainage alone is rarely effective, as cysts frequently recur. If the cyst doesn’t hurt, then keeping an eye on it is fair.

Rheumatoid Arthritis

Inflammatory arthritis is a symptom of the autoimmune disorder that causes it. The feet’s joints are usually among the first to feel the effects. Pain, swelling, and tenderness in the top of the foot are all symptoms of synovial inflammation in the MTP joints, midfoot joints, and ankles.

Symptoms are weariness and morning stiffness that lasts longer than 30 minutes. Joint damage can be avoided with the help of disease-modifying antirheumatic drugs if they are used early on. Anti-inflammatory drugs (NSAIDs), steroids, orthotics, and surgery are all possibilities.

Gout

When uric acid crystallizes and accumulates in the joints, it causes inflammatory arthritis. In many cases, the big toe joint is the first to experience the agonizing pain, redness, and swelling of an acute gout attack.

The intermediate MTP joints are also frequently affected by gout. Untreated, attacks can persist anywhere from 7-10 days.

Acute flares can be treated with anti-inflammatory drugs, colchicine, and steroids. Medications like allopurinol and febuxostat are available to help lower serum uric acid levels as a preventative measure.