Top of foot pain

Pain experienced on the top of the foot is less common than big toe pain, and there are likely to be fewer likely causes in the majority of cases. Generally speaking, the most likely causes of top of foot pain are tendonitis, a stress fracture or a midtarsal fault.


This is the most likely cause of tendonitis in the foot, and is usually caused by problems with the posterior tibial tendon. This is the main tendon which connects to the bones in the middle of the foot. A tendon connects muscle to bone, and this tendon starts in the calve ending at the top of the foot. It helps to keep the arches of the feet raised, and it helps to support the foot when walking. Other tendons which could be at fault are the tendons from the extensor muscles which pass over the front of the ankle.  The function of these tendons is to pull the top of the foot in an upwards position, working against the Achilles.  When these tendons become overstretched, inflamed or when they rupture competently they can be the source of intense pain, especially when trying to walk. Over time the problem can lead to flat feet.

The problem is common amongst athletes and people who are on their feet a lot for work, especially when unnatural pressures are placed on the feet.  It is most common in people over 50, and obesity, high blood pressure, trauma to the foot and rheumatoid arthritis can all be involved in the development of the condition. The problem will result in pain in the top of the mid foot, and may be accompanied by swelling, tenderness and weakness in the feet.

Stress Fracture

The second most common cause of top of foot pain is a stress fracture to the tarsal’s or metatarsals of the foot. The most common areas are the second and third metatarsal. Stress fractures are tiny fractures in the feet, which are not necessarily caused by trauma, but this is most common. In most cases they are due to overuse of the feet, and are common complaints with athletes and fitness fanatics. When on the feet for long periods, the weight bearing bones are at risk due to the muscles becoming tired, and failing to adequately function as shock absorbers, leaving the fragile bones of the feet at risk. Any condition which causes weak bones, such as osteoporosis can also lead to stress fractures without heavy high impact exercise.

Midtarsal fault

A midtarsal fault generally a problem which can result from flat feet. As the arches of the feet collapse, they cause undue stress on the midtarsal area and the bones jam together causing pain.  This is almost always the result of over pronation of the foot – or over flattening in layman’s terms. This is often easily rectified with orthotic soles, or shoes with excellent arch support.

Naturally if you are suffering from another foot condition then there is a chance that this could well be a contributory factor. People who have a hammertoe condition, where the toes are displaced tends to create pain in the ball of the foot on the underside, however they can contribute to top of foot pain. Pain can radiate out from the source of the problem and be felt in other areas of the foot. Having a bunion or bunionette can also cause pain on the top of the foot, although the source of the pain will at the base of the toe.

If you have recently changed medication, or are taking prescription drugs for another condition, there is a chance that the top of foot pain could be related. In all cases of foot pain the recommended course of action in the first instance is to visit a doctor or podiatrist for a full examination and thorough assessment. When this is not possible, resting and trying to keep weight off the foot should help and the pain may well go away after a short period.

Read more about the common causes of top of foot pain.