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    Saturday, May 20, 2017

    Pain On Top of Foot

    Pain on top of the foot can really affect our daily lives, affecting activities like walking, running and simply standing.  Our feet are one of the hardest worked parts of our bodies – with each step, a force of 1.5 times body weight goes through the foot. 
    It comes as no surprise that approximately 75% of Americans have foot pain at some point in their lives.
    There are a number of causes of top of foot pain. Here we will go through a brief overview of the 10 most common causes, looking at the symptoms and treatment options for each type of pain on top of foot.  To find out more about each one, click on the relevant links below.

    Top 10 Common Causes

    1)  Stress Fractures

    The most common cause of sudden top of foot pain without a specific injury
    Common sites of foot stress fractures
    What Is It: A small break in one of the foot bones, commonly one of the metatarsals

    Causes: Repetitive overloading of the foot e.g. jumping, kicking and running especially if there is muscle weakness and tightness or a sudden increase in activity levels

    Symptoms: Pain on top of foot which can be quite severe.  Tender to touch and swelling around the area

    Treatment Options: Rest (you may need crutches to keep the weight off your foot for a couple of weeks), ice, ankle/foot brace, medication and occasionally surgery

    Find out more about how to treat and prevent this common cause of top of foot pain in the Stress Fractures section.

    2)  Extensor Tendonitis

    What Is It: Irritation and inflammation of the tendons on the top of the foot
    Tendonitis, inflammation of the foot tendons, can cause pain
    Causes: Shoes that are too tight, calf tightness, spending long periods on your feet, altered foot biomechanics, walking/running on uneven surfaces or simply dropping a heavy object on your foot

    Symptoms: Gradual onset of swelling, bruising and pain on top of foot.  Tender to touch and may be uncomfortable wearing shoes

    Treatment Options: Change how you lace your shoes, use orthotics, rest, ice the foot, employ ultrasound, get a course of injections or stretch the calf muscles

    Find out more about how to abolish the pain in top of foot and prevent the problem from recurring in the Extensor Tendonitis section

    3)  Sinus Tarsi Syndrome

    This more uncommon foot problem tends to cause localised pain around the top of the foot towards the outside of the ankle
    Sinus Tarsi Syndrome causes pain on top of the foot
    What Is It: Inflammation and irritation around the Sinus Tarsi, a small channel between the ankle and heel bone that ligaments, blood vessels and nerves pass through

    Causes: It most commonly occurs due to instability, often the result of an ankle sprain. It can also be caused by poor foot biomechanics, or repetitive activities such as ballet and baseball

    Symptoms: Foot pain on top and outside of the ankle which gets better with rest and worse with activity. Ankle stiffness in the morning which eases with movement. Instability and tenderness to touch

    Treatment Options: Ice, exercises, joint mobilisations, stability training.  Complete rest from all aggravating activities is vital

    Visit the Sinus Tarsi Syndrome section to find out more about how to treat this common cause of pain on top of foot.

    4)  Hammer/Claw/Mallet Toe

    These are the most common cause of top of foot pain affecting the toes.
    What Are They: Deformities in the toes affecting the positions of the small toe bones
    Claw Toe results in the toe sitting in an abnormal position
    Causes: Poor fitting footwear is the most common cause of this type of top of foot pain, either high heels or shoe with a narrow toe.  They can also develop secondary to a toe injury, a neural or vascular problem or arthritis

    Symptoms:
     Pain and stiffness in the toes.  Abnormal toe positions.

    Associated Problems:
     Corns and calluses often develop on the toes secondary to Hammer, Claw and Mallet toe

    Treatment Options:
     Good fitting footwear toe stretchers e.g. the Yoga Toe, exercises, injections and surgery

    Find out more about how these three conditions present, how to tell the difference between them and how to treat them in the Hammer, Claw & Mallet Toe section.

    5) Gout

    Another common cause of pain on top of foot, especially around the big toe
    Gout is a common cause of pain and swelling in the big toe
    What Is It: A type of inflammatory arthritis due to high levels of uric acid which cause crystals to form in joints, most commonly the big toe

    Causes: Certain medical conditions such as diabetes make you more prone to developing gout, diet (food and drink rich in purines), obesity and genetics
    Symptoms: Sudden onset of intense pain, swelling, redness, heat and tenderness, commonly starting at night time.  Symptoms usually settle within a couple of weeks
    Treatment Options: Medication, ice, steroids
    Find out more including some great ideas on how to prevent gout attacks in the foot gout section.

    6)  Nerve Entrapment

    What Is It: Occurs when a nerve on the top of the foot gets pinched or squashed

    Causes:
     Swelling from an injury to the foot, tight footwear, or dropping something heavy onto the top of the foot

    Symptoms:
     Shooting or burning pain on top of foot sometimes accompanied by pins and needles and/or numbness

    Treatment Options:
     Good fitting footwear, RICE – rest, ice, compression and elevation

    7)  Athlete’s Foot

    Athlete’s foot can occur anywhere on the foot and affects approximately 15% of the population globally at some point in their lives.
    Athletes foot is a fungal infection on the skin
    What Is It: A fungal infection of the skin aka tinea pedis

    Causes: Poor foot hygiene. Anything that increases the moisture around the foot e.g. wearing tight shoes, damp socks, warm humid conditions.  Athlete’s foot is contagious and can be passed from person to person or via contaminated surfaces e.g. towels, floors and showers

    Symptoms:
     Foot pain on top, side and bottom. Scaly and flaking skin which is often itchy.  If left untreated, can develop swelling and blisters

    Treatment Options:
     Good hygiene measures, going barefoot, anti-fungal medication, tea-tree oil.  If left untreated the condition can get so bad that amputation is required

    8)  Ganglion Cyst

    What Is It: Small area of swelling that is filled with jelly-like fluid, usually around the joints of tendons in the foot.  They are generally harmless
    Foot ganglions can appear anywhere on the foot
    Causes: Can be related to aging or may develop after an injury when fluid escapes from the joint capsule and pools in the nearby soft tissues forming a ganglion cyst.  Often there is no obvious cause. 

    Symptoms: 
     Small ball of swelling ranging from the size of a pea to a golf ball.  Often pain-free unless it is pressing on a nearby structure e.g. a nerve

    Treatment Options:
     Many disappear over time without any treatment (can take years).  The fluid can be removed with a needle, known as aspiration or the ganglion can be surgically removed but in both cases they recur in 1-in-5 people

    9)  Tarsal Coalition

    What Is It: Tarsal Coalition is where 2 or more of the tarsal bones in the foot are joined together with a bridge of bone.  Affects approximately 1% of the population
    The abnormal joining of tarsal bones known as Tarsal Coalition can cause foot pain
    Causes: This is a congenital problem (i.e. present since birth) and often displays a genetic link

    Symptoms:
     Usually affects children aged 10-15 years old causing foot pain, stiffness and instability

    Associated Problems:
     Can cause recurrent foot and ankle sprains and abnormal foot biomechanics e.g. flat feet

    Treatment Options:
     Orthotics, immobilisation in a cast, surgery

    10)  Tibialis Anterior Tendonitis

    What Is It: Inflammation and degeneration of the Tibialis Anterior Tendon at the front of the ankle
    Inflammation in the Tibialis Anterior tendon causes pain on top of the foot
    Causes: Overuse or excessive stress through the tendon e.g. running, kicking and snowboarding particularly going downhill or on uneven surfaces.  Muscle weakness and tightness, poor foot biomechanics, inappropriate exercise technique

    Symptoms: 
    Pain on top of foot and front of the ankle.  Worse after activity or prolonged rest.  Symptoms usually come on gradually

    Associated Problems:
     Actions such as kneeling or kicking a ball are often painful

    Treatment Options:
     Rest, ice, exercises, medication, graded return to activity, orthotics

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