Pain on Top of Foot: Treatment Based on Cause
Medically reviewed by Adam H. Kaplan, DPM
Pain on the top of the foot can occur from injury or as a side effect of a medical condition. You may also experience swelling, numbness, tingling, or burning—depending on the cause of your foot pain. Conditions such as osteoarthritis, extensor tendonitis, and gout can cause pain on the top of the foot.
This article discusses additional causes of pain on the top of the foot, what you can do at home to relieve your symptoms, and when it may be time to see a healthcare provider for your foot pain.
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Causes of Pain on Top of Foot Without Swelling
Pain on the top of the foot from chronic medical conditions or injuries to specific structures, such as nerves, can cause pain without swelling.
Osteoarthritis
Osteoarthritis is a condition that causes cartilage (material providing padding between bones in a joint) to break down. This condition develops over time and is due to wear and tear.
While the foot isn't the most common site for osteoarthritis, five areas of the foot are sometimes affected:
First metatarsophalangeal joint (base of the big toe)
First and second tarsal metatarsal joints (near the middle of the foot, in line with the first and second toes)
Navicular-cuneiform joint (close to the ankle, in line with the big toe)
Talonavicular joint (at the crease where the ankle bends, in line with the big toe)
Osteoarthritis can cause pain, stiffness, and decreased range of motion. Swelling may be present with osteoarthritis, depending on the severity of the condition.
Peripheral Neuropathy
Peripheral neuropathy may occur from direct trauma to the nerve that supplies sensation to the top of the foot—the common peroneal nerve, a branch of the sciatic nerve. Some medical conditions may also cause peripheral neuropathy, including the following:
Alcoholism
Autoimmune disease
Diabetes
Hormonal imbalances
Kidney or liver disease
Poor blood flow to the nerve
Side effects of drugs (such as chemotherapy)
Vitamin deficiencies
In addition to pain, peripheral neuropathy can cause:
Muscle cramps
Muscle shrinkage
Muscle twitching
Numbness
Tingling
Related: What Causes Nerve Pain in the Foot?
Causes of Pain on Top of Foot With Swelling
Pain on the top of the foot accompanied by swelling is often the result of certain health conditions.
Gout
Gout is a type of arthritis that develops when there is too much uric acid in the body, causing crystals to form in a joint. While gout can affect any joint, it commonly affects the big toe.
Symptoms of gout come and go. During flare-ups, symptoms typically include:
Redness
Severe pain
Swelling
Warm skin
Extensor Tendonitis
Extensor tendons are located along the top of the feet and help lift the toes and the front of the foot when you walk. Extensor tendonitis is a condition caused by inflammation of these tendons.
Symptoms of extensor tendonitis often include:
Aching on the top of the foot or front of the ankle
Pain that gets worse with activity
Pain that increases when wearing tight shoes
Swelling
Lisfranc (Midfoot) Injury
Injury to the Lisfranc joint complex can cause pain on the top of the foot. This joint complex is located in the middle of the foot, where the long bones (beginning at the base of the toes) meet the smaller bones in the ankle—also called the tarsometatarsal joints.
Lisfranc injuries typically cause damage to the bones, ligaments that attach bone to bone, and cartilage that provides padding on the ends of the bones. These injuries often include broken bones and torn ligaments, leading to dislocation of the foot bones.
Symptoms of Lisfranc injury include:
Bruising on the top and bottom of the foot
Pain that increases with walking or standing
Swelling on the top of the foot
Related: Tendonitis of the Ankle and Foot
Treating Top of Foot Pain
You may be able to manage top-of-foot pain at home with the R.I.C.E. method or over-the-counter (OTC) medications. However, if an underlying condition causes your pain, you'll need to work with a healthcare provider to determine the appropriate treatment plan.
Teatment for Conditions that Cause Inflammation
Conditions that cause inflammation—such as osteoarthritis, extensor tendinitis, gout, and Lisfranc injury—often benefit from the R.I.C.E. treatment method:
Rest: Avoiding activities that increase symptoms
Ice: Applying cold to the affected area
Compression: Supporting the inflamed area with a bandage
Elevation: Propping the foot up, using gravity to help decrease swelling
Healthcare providers often recommend non-steroidal anti-inflammatory drugs (NSAIDs), such as Aleve (naproxen), Advil/Motrin (ibuprofen), and Bayer (aspirin), to help decrease pain and swelling with these conditions.
Pain medication, such as Tylenol (acetaminophen), can also be helpful.
In some cases, conditions causing foot pain require a period of immobilization using a splint or cast while the injured tissues heal. If you have a broken bone or torn ligament, your healthcare provider will probably recommend a period of immobilization.
Physical therapy is a common approach to help manage pain and improve function for people with conditions that cause foot pain.
Treatment for Peripheral Neuropathy
The most common cause of peripheral neuropathy is diabetes. Treatment for this condition targets the underlying cause and focuses on maintaining healthy blood sugar levels. This can include medications, such as over-the-counter topical capsaicin, and lifestyle behaviors, such as eating a healthy diet and exercising regularly.
When to Have a Foot Scan
If you have a foot injury, foot pain without an apparent cause, or experience difficulty walking on your foot, see a healthcare provider. They may order a foot scan to identify the cause of your pain. Types of imaging healthcare providers may use to examine your foot closely include:
Sometimes, other tests—such as blood work—help healthcare providers diagnose the underlying issue to determine appropriate treatment.
Summary
Pain on the top of the foot can be caused by damage to the bones, tendons, ligaments, or nerves. Common conditions that cause pain on top of the foot include osteoarthritis, peripheral neuropathy, gout, extensor tendonitis, and Lisfranc injuries.
These conditions are treated with home remedies, medications, immobilization, and physical therapy. Imaging tests—such as X-rays—are often used to help diagnose the underlying cause of pain on the top of the foot.
Read the original article on Verywell Health.
