Top of Foot Pain — How A Chiropodist Can Help

Is the top of your foot sore, red, burning or swollen? Do you have sharp or stabbing pain? Does it hurt to walk?

You could have a stress fracture, arthritis or sinus tarsi syndrome. Chiropodists are trained to assess and recommend treatment for these conditions.

Stress Fracture

Sudden onset pain without a specific injury on the top of the foot may be a stress fracture to a metatarsal bone. Usually, there is swelling in this area, and it is tender to the touch.  Stress fractures are most common in the metatarsal bones but may also occur in other small bones of the foot.

Common foot stress fracture sites are the heel (calcaneus), navicular bone (boat-shaped bone located in the top inner side of the foot) or metatarsals (5 long bones between the ankle and toes.

Top of Foot Pain Diagram


Another common area of pain can occur near the middle of the top of the foot, generally a bit to the outside of the foot. In this area of the foot, the tendons that go to the toes can become inflamed. This is called extensor tendonitis.

One cause of this is tight muscles in the back of the calf. When the calf muscles are tight, they place increased stress on the tendons on the top of the foot. These are the muscles that pull the foot upward and against the tightness of the calf muscles. Wearing shoes with a small heel will help to take the stress off of the tendons on the top of the foot.

Stretching of the calf muscle is also very helpful. Oral anti-inflammatory medications can help. When these measures do not work, custom orthotics are the next step. Properly designed orthotics can correct the alignment of the foot, thus taking the stress off of the inflamed tendons.


More generalized pain on the top of the foot along with swelling may be caused by degenerative arthritis. This is seen in people with flat feet or a slowly collapsing arch.

Another area of degenerative arthritis that causes pain on the top of the foot is in the area of the big toe joint. When the big toe joint does not work properly over time it causes pain in the joint when walking. Jamming of the joint can also cause bony spurs to form on the top of the foot.

Pressure from shoes in this area alone can cause pain. Treatment for these conditions consists of taking oral anti-inflammatory medications and functional foot orthotics. Surgery can be an option for degenerative arthritis about the big toe joint but tends to be of limited value for the area of the mid-foot.

Sinus Tarsi Syndrome

Another reason for pain on the top if the foot is sinus tarsi syndrome or tarsal tunnel syndrome.

Inside the small joints of the foot, there is a small canal between the bones called the sinus tarsi, or tarsal tunnel. There are several small ligaments in this area. These ligaments can become inflamed.

A common cause of this pain is due to a flattening of the foot, which pinches these small ligaments. Sometimes there is actual jamming of two bones causing the pain. There is a large nerve that runs inside this tunnel. If the bones or joints collapse, the nerve can become pinched and this often results in a very sharp stabbing pain through the top of the foot.

Treatment for Top of Foot Pain

There are several ways in which the top of foot pain are treated. Treatment depends on the cause and the severity of the pain.

  • Anti-inflammatory medication to reduce pain and discomfort
  • Custom orthotics to stabilize muscles and control foot function
  • Stretching and strengthening exercises for the foot and legs
  • Changing foot wear
  • Rest and ice
  • Limiting activities
  • Physical therapies such as laser, ultrasound or shockwave treatment
  • Surgery (for severe cases)

Rest is important to allow any injury to heal. Limiting activities and “taking it easy” can go a long way in healing. If the pain or injury is excessive, often a walking boot will be used to rest and immobilize the area.

If the pain is caused by improper footwear, the problem may be solved as soon as new, proper-fitting footwear is purchased.

Your chiropodist foot specialist will thoroughly assess your foot and create an appropriate treatment plan for you. This may include any or all of the options listed above. 

Trina Scarrow, BSc, DCh, is a Registered Chiropodist and Foot Specialist who has been helping patients for over 20 years.

Chiropodists and Podiatrists are the only regulated health professionals who specialize in treating conditions of the foot. In Ontario, there are 600 Registered Chiropodists and only 60 Podiatrists.

Chiropodists today must complete 7 years of post-secondary education before they get their professional designation. Chiropodists do complete case management of foot problems, including assessment, treatment and ongoing care.

Chiropodist Podiatry Foot Specialist Trina Scarrow Treating Feet

Chiropodist Trina Scarrow, BSc, DCh treating a patient with foot pain.

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I am an experienced Foot Specialist and Registered Chiropodist with locations in Guelph and Milton.

I provide a full assessment, biomechanical exams and gait analysis. I will be able to help address your foot discomfort with a variety of techniques including foot care treatment, custom orthotics, orthopaedic shoes, medication, laser or physical therapy.

I can help get your feet functioning better so you can feel better. Contact me today.