Pain on the top of the foot is a common problem, and the usual culprit that causes this pain is the presence of a spur or spurs on the top of the midfoot, a collection of joints in the middle of the foot. These spurs can develop for a variety of reasons, but often form as a direct result of either arthritis on top of the foot, or extra bone formation as a result of jamming of the joints during motion.
The spurs can lead to inflammation of the soft tissue on the top of these joints, in a manner similar to traditional arthritis. This pain is often aching after standing for awhile, but sometimes can also be felt as a sharp stabbing pain. The spur can also irritate the sensitive nerve bundle that runs over the top of the foot. In this case, the pain on the top of the foot is often felt as a stinging or burning sensation. Numbness, or the sensation the top of the foot is asleep, can also develop.
The pain on the top of the foot forms for several different reasons. In the case of inflammation on the top of the joints, the presence of a flat foot deformity leads to abnormal compression on the top of the foot. As one is standing or moving for a longer period, the strain to these joints increases. In the case of nerve irritation, the presence of a tight shoe tongue can compress the nerve between the shoe and the bone spur below the nerve. The longer this area is compressed, the more symptoms one will feel.
Treatment depends on which form of spur pain is present. In the case of an arthritic joint, the use of anti-inflammatory medications and an arch support to reduce flattening and compression of the foot can help. For nerve-related pain, the use of a less constrictive shoe or alternate lacing technique can help reduce pressure. For either of these conditions, the use of a steroid injection on the top of the foot may also reduce the inflammation and pain. Of course, a longer lasting treatment can be given that actually removes the aggravating spur. Surgery to shave the extra bone off the top of the foot is very effective at reducing the underlying problem, and usually leads to long lasting relief with a relatively short recovery period.