by A Morris

Created on: March 31, 2009

Pain on the top of the foot may be caused by several factors, and may in some instances indicate a condition that requires immediate attention. The foot has a complex structure, with 26 individual bones, not to mention nerves, cartilage, tendon and soft tissue. This can make problems of the foot very difficult to diagnose. In view of this, early treatment is paramount to prevent further development of a condition. The main causes of pain on top of the foot are; fractures, nerve entrapments, metatarsalgia and tendonitis. Less common causes are; shin splints and ankle impingements.

Fractures can cause acute pain across the top of the foot, depending on where the fracture has occurred. If you suffer unexplained pain along the top of the foot which gets worse when weight is borne upon it, it is advisable to see your doctor as soon as possible. Foot fractures usually heal between 4 to 6 weeks if attended to promptly. Continuing to walk on the foot without visiting a doctor may lead to an extended fracture or further complications.

Nerve entrapments occur when a nerve is pinched, either by becoming trapped in a joint or by way of a neuroma. A neuroma is a benign growth of nerve tissue that occurs between the inter-metatarsal space, and is usually caused by poor biomechanics, ill-fitting footwear or as a result of trauma to the affected nerve. (For more information on neuromas, please visit my article about Morton's Neuroma"). Neuromas can cause pain both underneath and on top of the foot, and can initially be difficult to diagnose. Nerve pain is often characterized by a burning sensation, changes in temperature and sensitivity to touch (allodynia).

Tendonitis usually occurs as a result of a strain. If a toe is over-flexed towards the floor, the patient may feel pain along the top of the toe joint. Likewise if a toe is bent upwards the pain will be felt underneath. Tendonitis occurs when the protective sheath around the tendon becomes inflamed, and the tendon itself becomes inflamed and painful. The best course of action for treating tendonitis is rest and ice. In the instance of inflammation in any part of the body, the standard recommendation can be remembered as R.I.C.E. (Rest, Ice, Compression, Elevation).

Metatarsalgia refers to pain in the metatarsal region of the foot. The metatarsal bones make up the length of the toes and attach to the mid-foot. Because the toes are used for every movement of the foot, this area can become inflamed for a variety of reasons, which are not always easily diagnosed.

I have mentioned shin splints and ankle impingements because, on occasion, they can result in pain along the top of the foot. Shin splints occur when the muscle tears away from the shin bone. In rare occurrences, shin splints can lead to severe muscle imbalances that can cause the muscles to contract and pull down the front of the ankle and into the foot. Regular stretching and soft tissue massage can help to relieve this, along with ice to remove inflammation.

An ankle impingement occurs when the nerve or tissue becomes trapped in the front of the ankle. This condition can occur when there is limited mobility and walking movements may be awkward. Because there is a strain along the front of the ankle, that pain can stretch down the length of the foot. Sports strapping techniques can be used to support the ankle, and exercise should be limited to gentle stretching.

In the case of any foot pain, it is advisable to consult a doctor as soon as possible. Feet are incredibly important and should be taken care of. It is always better to consult a doctor if in doubt, than suffer the consequences later.

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