Guelph:   (519) 823-1450

Milton:    (289) 242-3668

Stress Fracture

Sudden onset  pain without a specific injury on the top of the foot may be a stress fracture to a metatarsal bone. Usually there is swelling in this area,  and it is tender to the touch.  Stress fractures are most common in the metatarsal bones but may also occur in other small bones of the foot.



Another common area of pain occurs near the middle of the top of the foot, generally a bit to the outside of the foot. In this area of the foot the tendons that go to the toes can become inflamed. This is called extensor tendonitis. One cause of this is tight muscles in the back of the calf. When the calf muscles are tight,  they place increased stress on the tendons on the top of the foot.  These are the muscles that pull the foot upward and against the tightness of the calf muscles. Wearing shoes with a small heel will help to take the stress off of the tendons on the top of the foot.  Stretching of the calf muscle is also very helpful. Oral anti-inflammatory medications can help. When these measures do not work,  custom orthotics are the next step. Orthotics correct the alignment of the foot, thus taking stress off of the inflamed tendons.



More generalized pain on the top of the foot with swelling  may be caused by degenerative arthritis. This is seen in people with flatfeet or a slowly collapsing arch.

Another area of degenerative arthritis that causes pain on the top of the foot is in the area of the big toe joint. When the big toe joint does not work properly over time it causes pain in the joint when walking. Jamming of the joint can also cause bony spurrs to form on the top of the foot. Pressure  the shoes in this area alone can cause pain. Treatment for these conditions consists of taking oral anti-inflammatory medications and functional foot orthotics. Surgery can be an option for the degenerative arthritis about the big toe joint but tends to be of limited value for the area of the mid foot.



Sinus Tarsi Syndrome


Another reason for pain on the top if the foot is sinus tarsi syndrome, or tarsal tunnel syndrome.  Inside the small joints of the foot there is a small canal between the bones called the sinus tarsi, or tarsal tunnel. There are several small ligaments in this area. These ligaments that can become inflamed. A common cause of this pain is due to a flattening of the foot, which pinches these small ligaments. Sometimes there is actual jamming of two bones causing the pain. There is a large nerve than runs inside this tunnel. When the nerve is pinched if the bones/ joints collapse, this often results in a very sharp stabbing pain through the top of the foot.


Top of Foot Pain Treatment

There are several ways in which top of foot pain are treated. 

 Treatment depends on the cause and the severity of the pain.


Types of treatment include:

anti-inflammatory medication to reduce pain and discomfort.
custom orthotics to stabilize muscles and control foot function
stretching and strengthening exercises for the foot and legs
changing foot wear
rest and ice
limiting activities
physical therpaies such as laser, ultrasound or shockwave treatment
Surgery (for severe cases)

Rest is important to allow any injury to heal. Limiting activities and "taking it easy" can go a long way in healing. If the pain or injury is excessive, often a walking boot will be used to rest and immobilize the area.

 If the pain is caused by improper footwear, the problem may be solved as soon as new, proper-fitting footwear is purchased.

 Your foot specialist will create an appropriate treatment plan for you. This may include any or all of  the options listed above.


Top of foot sore, red, burning or swollen? Sharp or stabbing pain? Hurts to walk?

Custom Foot Clinic

& Orthotic Centre​​