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Our feet are made up of bones, tendons, nerves, ligaments, and muscles that enable it to
work properly, and walking, standing, and other everyday movements. These parts carry
our entire body weight all day long, so it’s relatively common in having foot pain. If
something goes wrong with just one of these tiny parts, it can throw your entire life out
of whack. Sometimes, we’ll feel top of the foot pain and swelling that can be
uncomfortable when walking and even standing still. This pain will be mild to severe,
depending on the cause of injury.
Foot pain makes simple tasks more challenging or even impossible. Many health
conditions and injuries can upset the foot’s movement and balance, causing problems
and pain. Any part of our foot can become painful for several reasons. Most foot pain
requires rest and extra care to heal. If the pain is for an underlying health condition, it
may need additional medical care. Here we focus on pain on top of foot causes and
potential treatments.
Anatomy of the Foot
The foot is one of the complex parts of our body. It comprises 28 (Talus, Calcaneus, 5-
Tarsals, 5- Metatarsals, 14 -Phalanges, 2 -Sesamoids) bones connected by 30 joints, 100
muscles, tendons, and ligaments all of which work simultaneously to provide support,
balance, and mobility.
There are many situations you can injure your foot, from dropping something on it to
turning it in the wrong way to simple overuse. Sometimes you might injure yourself and
not realize it until later when symptoms manifest. Other times, such as when you have a
sprain, a fracture, or a broken bone, you’ll notice right away. If the injury isn’t serious, your
foot will probably heal on its own.
Sudden onset pain without the incidence of trauma on the top of the foot just behind the
toes may be a stress fracture of the metatarsal bone. There is usually top of foot swollen
and painful to the touch. Conditions caused by overuse include:
Extensor Tendonitis
Inflammation of the extensor tendons on the top of the foot lifts the toes that will induce
top of foot pain. This is caused by overuse or tight-fitting shoes, flat feet, prolonged
standing/walking, muscle tightness, and off-road running. The tendons that run along the
top of the foot and pull the foot upwards become inflamed and painful.
Symptoms of extensor tendonitis are a gradual increase in pain, swelling & tenderness
on top of the foot. Discomfort enhances by wearing shoes.
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Symptoms of tibialis anterior tendonitis are a gradual increase in pain on top of the foot
and ankle and worse after rest.
Some characteristics are a pain in the anterior lateral side of the ankle and the feeling of
instability or pain on top of the foot from walking on unstable surfaces.
A stress fracture is a small break or severe bruising within a bone. Most stress fractures
are by overuse and repetitive activity and are common in runners and athletes who
participate in running sports, such as soccer, jumping, and basketball.
Symptoms of stress fractures are sharp pain on top of foot when walking, top of the foot
swollen, and tenderness over the fracture area on the top of the foot. Other causes of
pain on the top of the foot can comprise:
Bone Spurs
A bone spur is a painful bump on the top of the foot, which is a bony enlargement. This
bump is common where the first toe joint meets the mid-foot.
A hammertoe is a toe that has an abnormal bend in its middle joint, making the toe
bends downward to look like a hammer. It is the most common deformity of the second,
third, or fourth toe. It is usually caused by wearing tight shoes with little to no arch
support.
Claw toe generally involves the four smaller toes at the same time. The toes curl up at
the joint where the toes and the foot meet. They crouch down at the middle joints and
the joints nearest the tip of the toes. This leads to the toes to curl down toward the floor.
A mallet toe crouches down at the joint closest to the tip of the toe. It usually affects the
second toe, but it can happen in the other toes too.
Tight, pointed shoes, toe injury, arthritis, problems in nerves or blood vessels can
enhance hammer, claw, bunion, and mallet toes. This painful condition forms by an
imbalance in the surrounding muscles, tendons, or ligaments that normally keep the toe
straight.
Nerve Pain
Peripheral neuropathy occurs for pinching or compression of a nerve in the foot, leg or
the lower back can cause pain, prickling, or numbness that can spread up from the feet
into the legs.
Common peroneal nerve dysfunction is the dysfunction of a branch of the sciatic nerve
that can cause tingling and pain at the top of the foot, along with the weakness of the
foot or lower leg.
Symptoms of nerve pain are bruising top of the foot or shooting pain, pins, and needles,
numbness and foot weakness. Swelling, injury, spinal deformity, and disc bulge can
cause nerve pain.
Ganglion Cyst
A ganglion cyst is a small sac of fluid that develops over a joint or tendon. Inside the
cyst, there is a thick, sticky, colorless and jellylike material. Depending on the volume,
cysts may seem firm or spongy.
Symptoms of a ganglion cyst are small, pea-like nodules. It causes pain if presses on
nearby structures such as a nerve. A foot injury can cause a ganglion cyst, aging, and
often unknown origin can induce this condition.
Athlete’s Foot
Athlete’s foot is the fungal infection of the feet. It commonly occurs between the toes.
The athlete’s foot looks like dry, flaky, scaly skin. Symptoms often include burning, itchy
feet, flaking skin, swelling, and blistering.
The athlete’s foot can cause poor foot hygiene, excess moisture, humid conditions, and
contagious conditions.
Tarsal Coalition
The bony bridge connects two or more of the foot bones. Symptoms of a tarsal coalition
are stiffness, instability, and foot pain, commonly in early adolescence.
Gradual Onset Mild-Moderate Pain: Extensor tendonitis (pain on top of the foot), tibialis
anterior tendonitis (front of the ankle pain)
Stiffness and Instability: Sinus tarsi syndrome (after an ankle sprain), tarsal coalition (early
adolescence)
When you make a consultation with your physician, they’ll ask you about any other
symptoms and potential ways it could have injured your foot. They may seek about your
physical activity and any past damages to your feet or ankle. Your physician will then
review your foot. They may press on various areas on the foot to see where you feel pain.
Then, they will review your foot for any symptoms of swelling or deformity. They will
study at you walking and then review at the movement and strength in and evaluate the
range of motion.
To check for extensor tendonitis, your physician will ask you to flex your foot downwards,
and then try to pull your toes up while they resist. If you feel pain, extensor tendonitis is
possible the origin of top of the foot pain.
If your physician assumes a broken bone, fracture, or bone spurs, they’ll conduct an X-ray
of the foot.
If the pain is more extreme, is becoming worse, there is marked swelling or you cannot
bear weight, see your physician. Because our feet hold our entire body weight, a mild
injury could develop into a more extensive one if it goes untreated. Treatment depends
on determining the cause of the condition and may comprise:
Physical therapy, which can help treat conditions such as peripheral neuropathy, extensor
tendonitis, and damage to the peroneal nerve
A cast or walking boot for injuries such as broken bones or fractures
Orthotics
NSAIDs or other anti-inflammatory drugs, which can help reduce inflammation, including
inflammation from gout
Surgery is very rare case.
Home treatment
Home treatment can help with foot pain at most times. It would help if you rest the
affected foot as much as possible. You can apply ice to the affected area in the acute
phase for twenty minutes at a time or as you tolerate. Also, you may apply alternate cold
& hot therapy wrap after 72 hours of injury and 3 times a day. When you have to walk,
put on supportive, smooth-fitting shoes that aren’t too tight.
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