When talking about pain on top of the foot, we are referring to what’s called dorsal foot pain.
This can be due to a wide range of pathologies, and treatments differ depending on what is causing this pain.
This article will give an overview of the most common forms of dorsal foot pain, and what can be done to fix it!
Key Takeaways:
- Dorsal foot pain, or pain on the top of the foot, can be caused by various conditions such as midfoot osteoarthritis, tibialis anterior tendinopathy, dorsal jamming/hallux limitus, injury of the extensor tendons, corns, anterior ankle impingement, and stress fractures.
- Midfoot osteoarthritis is a common cause of dorsal foot pain, characterized by degeneration of cartilage between the bones in the midfoot. Treatment may involve orthotics to improve foot alignment.
- Tibialis anterior tendinopathy occurs when the tendon connecting the tibialis anterior muscle to the midfoot becomes damaged or overused. Rehabilitation typically involves exercises to strengthen the tendon and modifying footwear to reduce pressure.
- Dorsal jamming, often affecting the big toe joint, occurs when the bones rub against each other instead of gliding smoothly. Surgical intervention may be necessary if conservative measures fail, but conservative options such as footwear modifications or orthotics should be tried first.
- Other causes of dorsal foot pain include injuries to the extensor tendons, corns due to abnormal pressure on the toes, anterior ankle impingement caused by abnormal joint function or previous injury, and stress fractures resulting from repetitive force or trauma. Treatment approaches vary but may include exercises, footwear modifications, orthotics, or, in some cases, surgical intervention.
Midfoot Osteoarthritis:
Osteoarthritis can develop in joints throughout the body, including the hands, knees and feet.
In the feet, osteoarthritis is most common in the midfoot area. Our midfoot consists of the navicular bone, cuboid bone, and cuneiforms. Osteoarthritis occurs when the cartilage between two bones degenerates. Instead of having a nice smooth surface for the bones to articulate, we end up with one bone rubbing against another bone.
As you can imagine, this can cause a lot of pain, particularly on the top of the foot.
How this is treated will vary depending on which joints are affected by osteoarthritis and what the mechanism for this injury to occur was.
Orthotics can often help reduce painful symptoms by altering how your foot functions and spreading these bones out to assist with alignment.
Tibialis Anterior Tendinopathy:
The tibialis anterior muscle sits at the front of the leg next to the shin bone and is responsible for pulling your foot back towards your body, otherwise known as dorsiflexion.
Muscles attach to bone via tendons, and the tibialis anterior attaches into the midfoot area of the foot.
This tendon can become damaged if it is overused, or occasionally from poorly fitting footwear or laces that are done up too tight.
As seen in the picture to the right, damage to this tendon can result in pain along the front of the ankle, as well as the top and inside of the foot.
Rehabilitation of this injury will generally involve completing a range of exercises to increase the capacity or strength of the tendon, as well as addressing why this injury occurred in the first place.
Footwear modification or alternative lacing techniques may also help to relieve pressure.
Dorsal Jamming/Hallux Limitus:
Dorsal jamming usually occurs in the big toe. This refers to when the bones making up the metatarsophalangeal joint rub into each other at the top of the big toe joint instead of gliding over each other like a hinge.
This can result in bone grinding on bone and the formation of a lump or ‘lipping’ at the top of this joint. This can often be seen as a hard lump in the skin at the top of the big toe joint.
If left untreated for a long period of time, surgery is generally the only effective option to reduce pain, however it is often worth trialling a range of more conservative options before opting for surgery such as modifications to your footwear or orthotics.
If you think you may have an issue with your big toe joint, book an appointment with us today so we can help get your feet pain free!
Injury of the Extensor Tendons:
The tibialis anterior tendon is not the only tendon that runs across the top of the foot. Injuries may also occur that involve tendons of the extensor digitorum longus muscle or the extensor hallucis longus muscle.
These generally occur due to overuse and will be treated very similarly to an injury of the tibialis anterior, including a range of exercises and alterations to footwear.
Corns:
Pain on the top of the foot can often be due to corns, particularly on the tops of the toes!
Corns develop due to an abnormal amount of pressure being applied to the area, which is generally due to footwear and/or toe deformities such as hammertoes, clawed toes and mallet toes.
Luckily, corns can be removed by simply seeing a podiatrist and having them debrided and removed, which usually results in instant relief of pain.
If a corn continues to come back, the amount of pressure this area is receiving needs to be altered, so your podiatrist may offload this area using a variety of techniques.
If you have a sore spot on your foot that looks like the image to the right, don’t hesitate to come see us!
Anterior Ankle Impingement:
Impingement of the anterior ankle occurs when either abnormal function of the ankle joint, or a previous injury causes a build up of scar tissue at the front of the ankle.
Previous traumatic ankle injuries may also result in bone lipping or a bony block at the front of the ankle, which can also restrict motion.
When walking, this will often present as a pinch at the front of the ankle, as the joint can no longer function normally.
This may be treated in a variety of ways, including joint mobilization, orthotics and in some cases, surgical excision of abnormal tissue.
If you have pain at the front of our ankle, come book an appointment with us today to see what can be done for you!
Stress Fractures:
Stress fractures are caused from repetitive force or trauma and result in tiny cracks within the bone. They can also occur in those who have conditions such as osteoporosis or osteopenia, as these conditions result in weakened bones.
Stress fractures are common within the lower leg and feet, as these are the structures that take a lot of the load when we are standing, walking and running.
A sudden increase in activity, inappropriate footwear and hard training surfaces can also contribute to a stress fracture.
Those with a stress fracture will usually describe an aching pain that does not relieve with rest or at night.
Treatment typically involves a moon boot for approximately 6 weeks to immobilise and offload the area to allow it to heal. Following your stint in a moon boot, you will be prescribed a strengthening program and we may modify your footwear to prevent another stress fracture.
If you are suffering from dorsal foot pain, please don’t hesitate to book an appointment with one of our incredible podiatrists! Book online here, or call us on (03) 9432 2689.
