Sunday, March 03, 2024
FOOT PAIN Top of Foot Pain

Top of Foot Pain When Walking: Causes & Treatments for Pain in the Foot

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Your feet undergo a lot of stress and strain daily when walking. Your feet have bones, ligaments, tendons, muscles, and nerves in them. If you experience top of foot pain when walking, there could be a few reasons why.

In this article, you’ll learn about all the different conditions that could be causing top of foot pain when you walk. 

What Causes Top of Foot Pain When Walking?

Top of foot pain that occurs when walking is often caused by overuse of the tendons and muscles in the foot. Certain activities like jumping, marching, and running can also cause injuries to the bones in your feet.  

Another name for the top of the foot is called the “dorsal surface of the foot”.

Foot Conditions That Occur From Overuse

extensor tendonitis

1) Extensor Tendonitis

Your body has tendons that connect your muscles to your bones. These tendons play an essential role in movement. When a tendon in the foot becomes inflamed, it is known as “tendonitis.” 

The extensor tendon is responsible for enabling your foot and toes to move in an upward direction and is actively engaged when you walk. 

Certain factors can cause the extensor tendon to become inflamed, resulting in extensor tendonitis. 

Walking on an incline, particularly for an extended period, can overwork the extensor tendons, resulting in an achy pain on the top of the foot, along with swelling. 

Ill-fitting shoes can also make your feet hurt. 

Wearing tight, compressive shoes or tying your shoelaces too tightly can put excess pressure on the tendon, causing inflammation. 

Overuse caused by exercising is another common cause of extensor tendonitis. Starting a new workout regimen or suddenly increasing the distance you walk can trigger the condition. 

Therefore, it’s essential to be mindful of your body’s limitations and gradually increase the intensity and duration of physical activity.

2) Stress Fracture

If you experience dull, achy pain on the top of your foot when walking, you may have a stress fracture. You may also notice subtle swelling and difficulty bearing weight on the foot. 

Stress fractures are small cracks in the bone that can occur due to repetitive pressure in a specific area.

The most common area to develop a stress fracture in the foot is the 2nd metatarsal bone. However, stress fractures can be seen in any bone. 

Stress fractures are commonly seen in the 5th metatarsal base. These fractures are called “Jones fractures” and can be difficult to heal due to the poor blood supply in the 5th metatarsal base. 

Read more about treating foot stress fractures here

icing sinus tarsi

3) Sinus Tarsi Syndrome

The sinus tarsi is a tunnel where the ankle bone meets the heel bone. There are ligaments inside the sinus tarsi, as well as fatty tissue. 

When someone has a flatfoot foot structure or a “pronated” foot structure, the sinus tarsi will become pinched when they walk. Scar tissue can form inside the area and cause pain.  

If you have sinus tarsi syndrome, you will experience pain on the top of your foot and outside of your ankle. You may also notice swelling in the ankle. 

4) Tibialis Anterior Tendonitis

Tibialis anterior tendonitis is a condition that occurs when the tibialis anterior tendon becomes inflamed. The anterior tibial tendon is located on the front of the lower leg and runs down the shinbone and inserts into the foot. 

The tibialis anterior tendon is responsible for lifting the foot and controlling its movement during walking and running. 

When this tendon becomes overused and inflamed, it can cause pain and discomfort in the top of the foot when walking, resulting in tibialis anterior tendonitis. 

This pain is often described as a sharp sensation and may be accompanied by swelling or tenderness in the foot. In some cases, the pain may also radiate up the leg or down to the toes.

5) Plantar Fasciitis

The plantar fascia is the ligament on the bottom of the heel and arch. The plantar fascia aids with shock absorption when walking. It becomes inflamed due to overuse. When the ligament becomes inflamed, it will cause foot pain. 

Although plantar fasciitis is often associated with pain in the bottom of the foot, it can cause radiating pain to the top of the foot. 

When individuals have heel/arch pain, they may have difficulty walking. This causes the tendons on the top of the foot to work harder, thus causing top of foot pain. 

Read more about plantar fasciitis in this supplemental article: Plantar Fasciitis- The Ultimate Guide (From a Podiatrist)

stiff sole shoe

Other Causes of Discomfort on the Top of the Foot

1) Ganglion Cyst

If you experience pain on the top of your foot from walking, you may have a ganglion cyst.

ganglion cyst is a benign cyst that can form on the top of the foot. It can occur secondary to micro-trauma at the joint surface or along a tendon sheath. 

Generally, these cysts are not painful unless they are pressed upon or become large enough that they impinge on a nerve.

2) Tarsal Coalition

A tarsal coalition is when there are two or more tarsal bones in the foot that are fused. A tarsal bone is one of the several small bones that make up the back part of your foot and ankle.

You are either born with a coalition, or it can be acquired after an injury or due to arthritis. 

When you have a coalition, it restricts the range of motion in the foot joints. Restricted motion can cause pain in the foot, particularly in the top of the foot when walking. 

When the foot is in a dorsiflexed position (foot pointed up), the tarsal bones are compressed and can cause pressure on the surrounding soft tissue, leading to pain and swelling. 

Also, compensatory pain may occur, causing tendonitis on the top of the foot.  

3) Gout

Gout is a type of arthritis that occurs when uric acid crystals build up in the joints, leading to inflammation and pain. 

Gout is often seen at the big toe joint in the foot. However, it can occur in any joint. The pain from gout is caused by the deposition of uric acid crystals in the joint. 

When walking, the pressure placed on the affected foot can exacerbate the pain and make it difficult to bear weight. 

In addition to pain, gout can also cause stiffness and limited mobility in the affected joint. This can make your feet feel uncomfortable when walking. 

Read about foods to avoid gout in this article: List of Foods to Avoid With Gout (And What to Eat Instead)

4) Nerve Pain

Nerve pain on the top of the foot when walking can be caused by nerve compression/damage, injury, or underlying medical conditions.

One of the most common causes is nerve entrapment, which occurs when a nerve is compressed or pinched by surrounding tissues or bone spur. Wearing tight shoes can exacerbate nerve pain. 

Symptoms when walking includes pain, numbness, and tingling sensations in the affected area. 

In some cases, peripheral neuropathy secondary to diabetes may cause pain in the foot from walking. 

Check out the Ultimate Guide for Treating Nerve Pain on the Feet for more information on how to treat nerve pain. 

5) Hammertoe

A “hammertoe” is when the toe is bent at the middle joint, resembling a hammer or a claw. 

Hammertoes occur as a result of genetics and wearing improper shoes. 

Hammertoes can cause pain in the top of the foot when walking. The bent toe can rub against the shoe, causing friction and pressure on the top of the foot. This can lead to corns, calluses, or blisters, which can be painful and make walking difficult. 

To read more about hammertoes, check out this supplemental post: 7 Things You Didn’t Know That May Have Caused Your Hammertoes

5) Athlete’s Foot

Athlete’s foot (tinea pedis) is a fungal infection that affects the skin of the feet. It is a common condition among athletes, hence its name, but it can occur in anyone.

The infection typically begins between the toes but can spread to the soles of the feet and the top of the foot. 

Athlete’s foot can cause a variety of symptoms, including itching, burning, and redness. 

When the fungal infection affects the top of the foot, it can cause pain when walking, especially if the skin is cracked or blistered. 

The pain may be exacerbated by wearing tight or constricting shoes.  

To learn more about how to prevent Athlete’s Foot from spreading and recurring, check out this article. 

6) Ingrown Toenails

Ingrown toenails occur when a toenail border grows into the skin, causing pain, swelling, and redness. The pain associated with an ingrown toenail can also radiate to the top of the foot when walking.

When an ingrown toenail is left untreated, it can lead to an infection, which can cause the foot to become swollen and tender. 

This, in turn, can cause additional pressure on the top of the foot, resulting in discomfort and pain. 

Related article: Signs You May Need Ingrown Toenail Surgery

How Is the Pain Diagnosed?

When you make an appointment with your doctor, they’ll ask you about any other symptoms and potential ways your foot could have been injured. They may ask about your physical activity and any past injuries that you may have sustained.

Your doctor will then examine your foot. They will press on different areas on the foot to see where you feel pain. They will assess your foot structure and how you walk. 

If your doctor suspects a broken bone or bone spurs, they’ll order an x-ray of the foot to confirm this. 

If your doctor suspects that you may have a tendon injury, they may order a Magnetic Resonance Imaging Test (MRI)

An MRI will provide detailed images of the bones, tendons, and ligaments and help identify the presence of sprains and tears. 

If your doctor suspects nerve impingement, they will order a Nerve Conduction Velocity/Electromyography test (NCV/EMG)

The nerve conduction part of the test measures the speed and strength of the electrical impulses that travel along the nerves in the foot. Abnormal results can indicate nerve damage/compression. 

The EMG part of the test measures the electrical activity of the muscles in the foot. Abnormal results can indicate muscle weakness or damage caused by nerve dysfunction.

Blood work may be ordered to diagnose a condition, such as in the case of Gout.

In some cases, a procedure can help diagnose a condition. 

For instance, in the case of a ganglion cyst, your doctor may aspirate the cyst to confirm that it is a ganglion cyst. 

surgery foot

How Are Discomfort and Injury in the Feet Treated?

Treating pain on the top of the foot will depend on the diagnosis. 

For minor problems where there is minimal pain, you can try RICE therapy and reduce your activity levels. 

Rest

You should take a few days off of your foot to rest. If you simply cannot stay off your foot, you can try cross-training activities such as swimming or yoga.

Ice

Icing your foot can help prevent pain and discomfort in the foot

Compression

You can wrap your foot using an ACE bandage to help with the swelling and discomfort. 

Compression stockings are also very beneficial to reduce swelling. 

A good pair of compression stockings are the Jobst Activewear 20-30mmHg compression stockings. 

Make sure that you measure your ankle and calf circumference to find out your exact size before ordering your socks. 

You should wear the stockings during the day, and remove them at night. You can wash them and reuse them.

One pair of stockings is usually good for 6 months of compression.

Elevation

Elevating your foot using a couple of pillows is also helpful to relieve the throbbing and achy pain you may experience.  

However, if the foot pain is severe, and your pain is present for more than a couple of weeks, you should see your local Podiatrist. 

Fractures in the foot are treated with immobilization or surgery. 

Whereas tendonitis or plantar fasciitis in the foot may be treated with orthotics and physical therapy. 

Serious Health Conditions That Require a Podiatry Referral

Certain health conditions like gout, fractures, and tendon tears in the foot warrant an immediate Podiatry visit. That is because these issues can cause further damage to the foot if they are not treated quickly and correctly. 

holding top of foot

Conclusion

Foot pain when walking is frustrating. It’s natural to want to walk through the pain. However, it’s important to understand that sometimes resting the foot may be necessary.

If you notice persisting pain on the top of your foot despite changing your shoes/inserts and modifying your activities, it’s time to contact your doctor so that you don’t injure your foot more.

Getting an accurate and early diagnosis with appropriate treatment is important to ensure that you can continue walking without pain and maintain proper foot health.

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Vaishnavi Bawa
Dr. Vaishnavi Bawa is a Podiatrist who specializes in treating foot and ankle pathology. LifesLittleSteps mission is to educate the public about foot health in an easy-to-understand manner using evidence-based medicine.
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