Pain on the top of the foot can be caused by various conditions such as bone fractures, tendonitis, inflamed ligaments, arthritis, bone spurs, or a tarsal coalition. Treatment may include stretching, anti-inflammatory drugs, casting, surgery, or orthotics depending on the cause. Stress fractures, tendonitis, and degenerative arthritis are common causes. The tarsal coalition can cause pain towards the outer edge of the foot in children and young adults.
Pain on the top of the foot can be caused by bone fractures, tendonitis, inflamed ligaments, arthritis, bone spurs, or a tarsal coalition. The location of the pain and its occurrence help doctors make an accurate diagnosis and recommend appropriate treatment. Depending on the cause of the pain, treatment may be stretching, anti-inflammatory drugs, casting, surgery, or orthotics.
Stress fractures can cause pain on the top of the foot. Athletes, especially runners, tend to experience stress fractures in line with the second, third or fourth toes. A tear can also occur when there has been no injury to the foot immediately preceding the pain. The pain tends to be sharp, can come on suddenly, and the area can feel sore and swollen. Treatment usually consists of nonsteroidal anti-inflammatory drugs, ice, and rest.
If the pain is on the inside top of the foot, the navicular bone may have a stress fracture. This type of fracture can be difficult to diagnose because it doesn’t always show up on X-rays. Many times a CT scan or MRI is needed to make the diagnosis. If your pain is caused by a stress fracture, your doctor may recommend anti-inflammatory medications, shoe inserts, limited activity, and/or a cast. Surgery is rarely needed.
Tendonitis is another very common cause of pain in the top of the foot. Tight calf muscles can cause extensor tendonitis, or inflammation of the extensor tendon that connects the ankle to the bones in the foot. Extensor tendonitis pain is localized to the upper middle and outer edge of the foot. Orthopedists may suggest wearing a shoe with a 1 inch (2.5 centimeter) heel, calf muscle stretches, anti-inflammatory medications, or orthotics.
Inflamed ligaments can cause pain in the area below the ankle to the outside of the foot. Three small ligaments cross this area. These ligaments can become inflamed if a person has flat feet or if the two bones that run alongside the ligaments press against each other. Calf muscle stretches, anti-inflammatory medications, or orthotics may help. Your doctor might recommend cortisone injections or, rarely, surgery.
Degenerative arthritis in the big toe joint is another reason you may have pain in the top of your foot. If the joint is jammed, a bone spur may occur. Wearing shoes can aggravate the condition. Anti-inflammatories and orthotics are the most common treatments. Surgery is sometimes prescribed for severe cases of arthritis of the big toe.
Children and young adults may have pain in the foot that is more towards the outer edge. The tarsal coalition, or a fusion of two or more bones in the foot, may be responsible for the pain. It tends to get worse with any activity. If not treated early, tarsal coalition can lead to severe arthritis. Orthotics are generally used to treat tarsal coalition.
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