Why Does the Top of My Foot Hurt When I Walk?

Symptoms of pain in the top of the foot can vary depending on the cause and may include: 

• Pain
  • May range from mild to moderate to severe
  • May be sudden or severe when anything touches the foot
  • May start near the bottom of the big toe
  • May worsen with activity
  • May be worse after resting
• Swelling
• Bruising
• Stiffness that lasts a long time
• Grating or crackling sensation when moving the foot
• A lump along a tendon
• Red, hot, swollen skin
• Abnormal toe curling
• “Pins and needles” feeling or numbness

See a doctor for pain on the top of the foot and: 

• Pain prevents you from taking part in normal activities
• Pain worsens or keeps returning
• Pain does not improve after home treatment for two weeks
• Any tingling or loss of sensation in the foot
• You have diabetes 
  • Diabetes affects nerves, blood vessels, and blood flow
  • People with diabetes should see a podiatrist regularly to manage diabetes-related foot problems

Go to a hospital’s emergency department for pain on the top of the foot and:

• Pain is severe 
• You cannot walk
• You heard a snapping, grinding, or popping noise when an injury occurred
• You feel faint, dizzy, or nauseated from the pain
• The foot has changed shape or is at an odd angle

The cause of pain in the top of the foot is diagnosed with a patient history and a physical examination of the foot. 

Depending on the suspected cause, tests may include: 

• X-ray
• Magnetic resonance imaging (MRI) scan
• Blood tests

Treatment for pain in the top of the foot depends on the cause. 

For many types of foot pain, the RICE method can be used: 

• Rest: keep weight off the affected foot
• Ice: to decrease pain, swelling, and redness
  • If an injury is iced immediately, it may prevent some inflammation
  • Use an ice pack or ice wrapped in a towel
  • Apply crushed ice for 15 to 20 minutes at a time, several times daily
• Compression: to support the foot and prevent inflammation
  • Use elastic wraps such as Ace bandages
  • Do not wrap too tightly
• Elevation: propped up the affected foot to help reduce fluid buildup in the injured tissue
  • Try to raise the foot above the level of the heart

Other home remedies for pain in the top of the foot include: 

• Wearing roomy shoes with a low heel and soft sole
• Using soft insoles or pads inside the shoes
• Losing weight if overweight
• Gentle stretching exercises of the foot and ankle
• Taking acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) for pain

Avoid:

• Sports or other activities that may have caused the pain
• Walking or standing for long periods
• Wearing high heels or tight or pointy shoes

If pain on the top of the foot is more severe, treatment may include:

• Crutches
• Splint or cast if a bone is fractured
• Physical therapy
• Orthotics (prescription shoe inserts)
• Acupuncture
• Foot surgery (uncommon)