Pain on top of foot near arch

While pain in the top of the foot, or midfoot, may seem unusual, it is a very common symptom for a foot and ankle orthopaedic surgeon to see in practice.

Midfoot Injury

The first thing to think about is if a potential injury occurred.  For example, a heavy object falls on a person’s foot.   They are sore and not active for a little while, improve to some extent, but continue to have midfoot pain several weeks later. It can be easy to forget the initial incident as a potential cause for the pain. Automobile accidents are also a common source of injury.

A group of small bones make up the Lisfranc area or midfoot. These bones form the arch from the heel to the ball of the foot. Crush or twisting injuries to the midfoot can result in fractures or ligament damage in the midfoot.  Such fractures and ligament tears are often referred to as Lisfranc injuries.  Walking is often very painful, and there is often tenderness, swelling and bruising.

Another common cause of midfoot pain is a stress fracture.  Most commonly, stress fractures occur during an increase in running or other impact activity.  Runners who are increasing mileage in preparation for a race and high school athletes engaged in pre-season track or cross-country conditioning are two situations where we see midfoot stress fractures.

Fracture of Fifth Metatarsal

If the pain is concentrated towards the outside of the midfoot, the trouble may involve the fifth metatarsal. This bone connects the middle of the foot to the pinky toe and is one of the easiest bones in the body to fracture without realizing it. Some common instances are:

• Jones Fracture: when the bone fractures near the middle outside of the foot
• Avulsion Fracture: when a tendon or ligament pulls a small piece of the bone out of place. Most often, this happens during an ankle sprain.
• Midshaft Fracture: when the bone breaks in the middle, usually from an accident or severe twisting of the foot.

Extensor Tendinitis

The extensor tendons are run alongside the top of the foot and are needed for pulling the entire foot upward so that the toes are pointing towards the sky. If they become torn or inflamed due to overuse or wearing shoes that don’t offer proper arch support, this is diagnosed as extensor tendinitis.  Pain tends to increase with activity, and swelling is also common.

Arthritis or Other Long-Term Conditions

With so many small bones and joints, the foot is a common place for arthritis to occur.  Painful arthritis can occur at the base of the big toe, in the midfoot toward the top of the arch, and in the hindfoot.

Diabetes and Gout can also lead to pain on the midfoot. Pain from gout usually comes on quickly,  It more commonly seen in the big toe than on the top of the foot.  Diabetes can lead to neuropathy, where the small nerves in the foot and ankle don’t work properly.   Symptoms of neuropathy often start in the toes and are characterized by burning and numbness.

Ganglion Cysts

A ganglion cyst appears as a bump underneath the skin. These are typically fairly simple to diagnose, but the pain they cause will be dependent on their location. Is the cyst putting pressure on a nerve, muscle, joint or the shoe? The cyst’s proximity to any of these things will make it more painful.

Treatment

As you can see, pain on top of the foot can be a sign of many different issues. At OrthoNebraska, our first goal is to arrive at an accurate diagnosis based on the medical history, a physical exam and, in many cases, imaging tests like X-ray or MRI.

Treatment will depend on the underlying cause of the pain and how much it impacts your daily life. From most conservative to invasive, treatments considered may include:

• Rest
• Inserts
• Splinting
• Over-the-counter medication such as ibuprofen
• Prescription medication
• Steroid injections
• Physical therapy or exercises
• Minimally-invasive surgery
• Open surgery

Most causes of midfoot pain can be treated without surgery.  Almost always, we initiate conservative, non-surgical treatment, moving from least invasive to more invasive.

Further pinpoint your top of foot pain, or call (402) 609-3000 for an appointment if you are interested in an accurate diagnosis for your foot or ankle problem.

Foot pain is debilitating, so it’s no wonder that so many people want answers quickly. However, if you rely on internet searches, you will probably assume that your pain is caused by plantar fasciitis. However, just because there are a lot of articles on the condition doesn’t mean that’s what’s hurting you.

Plantar fasciitis is a common condition that causes terrible irritation, inflammation, and stabbing pain in the foot. It can affect the arch, heel, or both. But it’s not the only condition

While plantar fasciitis is common, other conditions can mimic this condition with the same symptoms. Overuse, bone spurs, and other issues can lead to pain in the foot arch, or heel. Unfortunately, people often self-diagnose with plantar fasciitis instead of getting the help they need. Without a real diagnosis and correct treatment, the problem can get worse.

Explore common conditions that cause foot arch pain but are not Plantar Fasciitis below. For professional diagnosis and treatment, contact the doctors at Arizona Foot Doctors in Scottsdale.

Cavus foot vs plantar faciitis

In some, heel pain may be the result of cavus foot. Cavus foot describes feet that have a very high arch, and, as a result, an uneven or incorrect distribution of weight occurs. Cavus foot is typically an inherited physical irregularity, but it can occur as a result of a neurological problem like a stroke or cerebral palsy. People who have cavus foot feel foot pain when standing or walking. They may also suffer from calluses, hammertoes, and or claw toes.

Cavus foot can lead to a range of other manifestations, such as frequently sprained ankles, increased pain in the shins and calves, and a higher chance of a stress fracture in the foot. While an individual with cavus foot may experience foot arch pain, it does not necessarily mean they are also experiencing plantar fasciitis. However, the two often go hand in hand. If you are experiencing cavus foot, work with a podiatrist who can determine a treatment that targets both conditions. Treatment for both conditions includes supportive footwear (custom foot orthotics are recommended), calf stretches, and physical therapy. If a neurological condition causes cavus foot, the treatment varies depending upon which neurological condition. When getting your annual healthy foot check-up with one of our podiatrists at Arizona Foot Doctors, treatment and support options can be discussed.

Overpronation

If you’re experiencing foot arch pain, heel pain, or ankle pain, talk to your doctor about gait. If, when taking a step, your heel hits the ground first, and then you feel pressure inward on your arch, it could be because you’re overpronating and therefore over-flattening your foot. If this isn’t as noticeable, look at the bottom of your most worn shoes. On the sole, if there are more wear and tear on the arch’s heel and inner area, this may be a sign that you overpronate when you step.

In some cases, overpronation can cause pain in your knees, hips, or back due to improper gait. Eventually, overpronation can damage muscles, ligaments, and tendons and lead to Plantar Fasciitis if left unsupported. If you or a loved one are experiencing discomfort such as foot pain or arch pain, reach out to your podiatrist. A podiatrist may recommend stretches, physical therapy exercises, or orthotics to help patients correct overpronation.

Posterior tibial tendon dysfunction

A condition known as posterior tibial tendon dysfunction (PTTD), also known as adult-acquired flatfoot, can sometimes arise due to past traumas of the foot or ankle, past surgeries of the foot or ankle, or hypertension. These injuries can cause
inflammation to the posterior tibial tendon, which is responsible for the connection between the calf muscle and the inner foot. Prolonged inflammation and degeneration will weaken the tendon, meaning the tendon can no longer support the foot’s inner arch. You may experience this foot arch pain that is not Plantar Fasciitis but may seem like it at first.

Someone with PTTD may experience pain and swelling in the arch of the foot, weakness in their foot, and may not be able to perform a heel raise. There are a variety of treatment options depending on the progression of PTTD. A podiatrist can collaborate with you and your lifestyle in mind to treat and manage your PTTD symptoms.

The importance of a professional diagnosis

If you are suffering from pain in the heel or arch of your foot, or have questions about your foot health, it is important to visit a podiatrist for a professional examination and diagnosis. The treatment options for different foot conditions vary, and they can range from noninvasive to invasive. A podiatrist may also use various diagnostic methods that also vary from noninvasive to invasive.

Our team at Arizona Foot Doctors are dedicated to getting you back on your feet. We understand that not every patient needs the same treatment, because every individual is unique. Schedule your appointment online or by calling us at (480) 661-7572.

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