Why do I get pain in my top of foot? Top of foot pain is common in all individuals whether they are weekend warriors, elite athletes or just a busy working mum that has to spend all day on their feet! The main conditions are plantar fasciitis, metatarsalgia and tendonitis but depending on the situation it may be referred pain. Plantar fasciitis affects the bottom of the foot predominantly but the pain may refer to the top of the foot as well as the heel. Metatarsalgia or the ball of foot pain may also radiate to the top of foot. The most common cause is Tendonitis. Foot biomechanics or the way that we walk and stand affects every aspect of the foot and if our biomechanics are incorrect it may cause undue stress in particular parts of our foot therefore causing pain.
Another cause of top of foot pain is over-explaining the function of the foot and toe through excessive activity, such as through running or sports. Overstanding can cause strains to the muscles and tendons of the foot leading to pain. Poorly fitting or unsuitable footwear is a very common cause of foot complaints. It can cause pressure on sensitive areas of the foot resulting in pain, or restriction to the normal movement and function of the foot, again resulting in pain, including pain to the top of the foot. Heavy wear of high heeled or flip flop type of shoes can cause long term stress to the foot that can lead to pain and discomfort.
The top of the foot is where people commonly experience pain when they have a foot injury. Symptoms can be varied, and can include pain, swelling and redness, as well as tenderness. Pain may be sharp, dull or achy, and can worsen with activities such as walking or exercise. Pain from the top of the foot can make it difficult to do everyday tasks, such as going to work, playing sports, or even simply getting around the house. Many people will start to avoid doing things they enjoy because they worry it will make their pain worse.
A variety of medical conditions can cause top of foot pain. For example, arthritis can develop in joints and cause inflammation and pain. Neuropathy, which is commonly associated with diabetes, is a condition where nerve damage develops, causing pain in different parts of the foot – including the top of the foot. Due to the complexity of the foot, any underlying medical conditions may have varied and not-so-obvious manifestations that may lead to difficulties in diagnosis and treatment.
The best way to manage the top of foot pain is to catch it early. If you notice some pain at the top of the foot you can start by making some changes to your lifestyle, by using shoe inserts and by seeing your doctor. Other simple steps you can take to reduce foot pain include: Wearing supportive shoes during all times of day, including at night, to reduce pressure on the foot and heel. Practicing proper foot care techniques such as washing, drying and moisturizing the feet on a regular basis. The International Foot and Ankle Biomechanics Conference was held in Austin in 2013 and shed a bit of light on how foot posture and function affects lower extremity pain. Overall, the better that you treat and manage your feet the better that you will be able to live out your daily life without any type of foot pain. There are a number of different treatments that can be used to treat pain at the top of the foot. Most common is rest and cold to reduce swelling and pain in the foot. Physiotherapy is also very beneficial in helping to heal pain at the top of the foot to go away. It is very important to work on the muscles of the foot and ankle as much of the top of the foot pain is due to injury to the muscles of the foot and foot movements. The doctors may also recommend orthotics, which are shoe inserts designed to improve foot function. By improving foot and foot function the orthotics can reduce pressure and stress to the top of the foot during standing and walking activities (Cooper, 2023).
Over-the-counter anti-inflammatory drugs like ibuprofen and naproxen can also help reduce pain and inflammation. If the pain doesn’t subside with these treatments, additional diagnostic procedures such as X-rays and MRIs may be necessary to uncover the source of the pain and confirm the extent of the damage (such as fractures or stress fractures) (Stewart, 2008).
We sometimes underestimate the effect an untreated top of the foot pain can have on a person’s life. For a person living with on-going pain, everyday activities such as walking and standing can become challenging and often unsustainable. Consequently, life can change in multiple ways. The person may find they are unable to do things they need to, or want to do. They may miss work, be unable to shop or have to forego visiting friends and family, due to their symptoms. In an attempt to “spare themselves pain” some people will start to withdraw from social events, because they worry they will over-extend themselves, (and thus exacerbate their condition), or worry that they will “pay the price” later with significant pain. Leisure time can be lost, and participation in favourite activities often reduce significantly, due to fear of being unable to manage, or that it will cause a lot of discomfort the following day. As reported by Hagedorn et al. (2013) people often do a lot to “catch up” on “missing out” as well, which further reduces what one is able to do each day.
Another factor is psychological. Chronic pain often leads to a feeling of hopelessness and irritation. As time progresses, many patients start to experience a fear of movement and pain-related anxiety. They begin to avoid carrying out various tasks and activities as a result of their pain, which in turn can lead to depression in some individuals. Combining foot pain with the psychological struggle for management is not easy for many patients and is associated with depression (Curatolo et al., 2001).
For these reasons, both physical and psychological factors must be addressed when dealing with top of foot pain. This should include medical treatment, as well as adequate psychological support. Dealing with top of foot pain can be difficult and it may take some time to get used to the changes in the body. Many people who live with chronic pain must also deal with a range of psychological and emotional symptoms, such as anxiety, depression, fear, as well as stress. Talking to a counsellor or joining a support group may be a good place to start. Finding ways to manage physical and emotional symptoms of pain can greatly improve the quality of life and help a person to return to normal activities, and therefore, the things they enjoy (Tate et al., 2012).
Citations:
Saljoughian, M., 2014. Foot pain etiology: an overview. US Pharm, 6, p.19. https://www.uspharmacist.com/article/foot-pain-etiology-an-overview?utm_source=TrendMD&utm_medium=cpc&utm_campaign=US_Pharmacist_TrendMD_0
Gutteck, N., Schilde, S. and Delank, K.S., 2019. Pain on the plantar surface of the foot. Deutsches Ärzteblatt International, 116(6), p.83. https://pmc.ncbi.nlm.nih.gov/articles/PMC6435866/
Joseph, S.Y., Spigos, D. and Tomczak, R., 1999. Foot pain after a plantar fasciotomy: an MR analysis to determine potential causes. Journal of computer assisted tomography, 23(5), pp.707-712. https://journals.lww.com/jcat/_layouts/15/oaks.journals/downloadpdf.aspx?an=00004728-199909000-00013
Stewart, J.D., 2008. Foot drop: where, why and what to do?. Practical neurology, 8(3), pp.158-169. https://pn.bmj.com/content/8/3/158.short
Riskowski, J.L., Dufour, A.B., Hagedorn, T.J., Hillstrom, H.J., Casey, V.A. and Hannan, M.T., 2013. Associations of foot posture and function to lower extremity pain: results from a population‐based foot study. Arthritis care & research, 65(11), pp.1804-1812. https://acrjournals.onlinelibrary.wiley.com/doi/abs/10.1002/acr.22049
Bhojani, K.S. and Kalke, S., 2010. Approach to foot pain. Indian Journal of Rheumatology, 5(3), pp.124-130. https://journals.sagepub.com/doi/abs/10.1177/0973369820100305
Cooper, M.T., 2023. Common painful foot and ankle conditions: a review. Jama, 330(23), pp.2285-2294. https://jamanetwork.com/journals/jama/article-abstract/2812902
Hagedorn, T.J., Dufour, A.B., Riskowski, J.L., Hillstrom, H.J., Menz, H.B., Casey, V.A. and Hannan, M.T., 2013. Foot disorders, foot posture, and foot function: the Framingham foot study. PloS one, 8(9), p.e74364. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0074364
Curatolo, M., Petersen-Felix, S., Arendt-Nielsen, L., Giani, C., Zbinden, A.M. and Radanov, B.P., 2001. Central hypersensitivity in chronic pain after whiplash injury. The Clinical journal of pain, 17(4), pp.306-315. https://journals.lww.com/clinicalpain/fulltext/2001/12000/Sensory_Assessment_of_Regional_Analgesia_in.00004.aspx
Tate, A., Turner, G.N., Knab, S.E., Jorgensen, C., Strittmatter, A. and Michener, L.A., 2012. Risk factors associated with shoulder pain and disability across the lifespan of competitive swimmers. Journal of athletic training, 47(2), pp.149-158. https://nata.kglmeridian.com/view/journals/attr/47/2/article-p149.xml
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