If you’ve ever felt a sharp or burning pain on the top of your foot, especially when walking or running, you’re not alone. Top of foot pain is a common complaint we see in the clinic—and it can stem from a few different issues.
Some people describe it as a tight, hot ache that comes and goes. Others say it hurts when walking but not when touched. Whatever your symptoms, the good news is that most causes are treatable with rest, footwear changes, and physiotherapy.
Let’s break down what might be going on, and how to get relief.
What Does It Mean When the Top of Your Foot Hurts?
Pain on the top of your foot (sometimes called dorsal foot pain) often means there’s irritation in the tendons, joints, or small nerves that run across the foot. It can also point to overuse injuries from running or walking, tight footwear, or even arthritic changes in the midfoot.
You might notice:
- Pain when you flex or extend your toes or lift your foot
- A burning or tingling sensation that comes and goes
- Tenderness or swelling across the middle of the foot
- Pain that’s worse in shoes but eases when barefoot
- Discomfort after running, walking uphill, or standing all day
Common Causes of Top of Foot Pain
Here are a few common types of pain on the top of your foot:
Extensor Tendonitis
Extensor tendons help you lift your toes and pull your foot upward. When they’re irritated, often from tight shoes or overuse, they can cause a sharp, aching pain along the top of your foot.
What does extensor tendonitis feel like?
Pain that worsens when pulling your toes up or while walking when you first put weight on your foot, swelling across the top of the foot, and tenderness to touch.
Treatment for extensor tendonitis:
Initially, rest, ice, gentle stretching, and adjusting footwear or lacing patterns are effective. Physiotherapy will also help to calm inflammation, restore proper movement, reduce muscle tension and rebuild strength. Shockwave therapy, taping techniques, acupuncture or IMS can help with this as well.
Stress Fracture
Repetitive stress can create microscopic cracks in the metatarsal or tarsal bones. This is common in runners, dancers, people who participate in impact activities or anyone who’s recently increased their activity level.
What does a stress fracture feel like?
Localized pain that increases with activity and eases at rest, sometimes with swelling but no bruising. Often pain can be felt at night time while sleeping.
Treatment for a stress fracture:
Rest, offloading with supportive footwear or a boot, and gradual return to activity. Physiotherapy to ensure proper movement patterns of all the joints involved, full flexibility and restore strength.
Nerve Compression (Dorsal Cutaneous Nerve Irritation)
Nerve compression, also known as Dorsal Cutaneous Nerve Irritation, can result from tight shoes or trauma and can irritate nerves on the top of your foot.
What does nerve compression feel like?
Burning, tingling, or numbness, often described as a hot pain on top of the foot that flares and fades.
Treatment for nerve compression:
Loosening footwear, adjusting laces, nerve gliding exercises, and physiotherapy to improve mobility.
Midfoot Arthritis
Midfoot arthritis is caused by arthritic or degenerative changes in the tarsometatarsal joints or between the tarsal bones in your foot that can cause chronic aching pain on the top of the foot, especially after walking or standing.
What does midfoot arthritis feel like?
If severe, pain is felt with walking or any weight bearing activities. If the arthritis is not as severe, deep stiffness or tenderness across the midfoot will be felt, which is often worse in the morning or after activity.
Treatment for midfoot arthritis:
Supportive shoes, orthotics, Physiotherapy treatments including joint and soft tissue mobilization, taping techniques, and exercises to improve strength and flexibility.
Tight Footwear or Lacing Pressure
Sometimes, the simplest explanation is the right one, tight footwear or pressure from lacing. Shoes that press down on the top of your foot can cause pain, swelling, or even nerve irritation.
Treatment for pressure on your foot:
Loosen your laces, skip eyelets over the sore spot, or try a roomier shoe.
Runner or on your feet all day? Get a tailored plan today.
How to Get Rid of Top of Foot Pain
Here’s how to relieve pain and prevent it from coming back:
- Rest & Ice/Heat: Avoid activities that aggravate pain and if the pain is within the first few days, apply ice for 15-20 minutes two or three times a day. If the pain has been lasting longer, heat usually is more helpful.
- Check Your Shoes: Switch to footwear with a higher toe box lower heel, a wider toe box and proper arch support.
- Try Gentle Stretches: Stretch your calves and the top of your foot to reduce tension.
- Strengthen the Foot: Exercises that build arch and ankle stability can prevent recurrence.
- See a Physiotherapist or Podiatrist: They can identify the cause, provide hands-on treatment, and guide your recovery.
- Address Underlying Factors: Poor biomechanics, overtraining, or lack of recovery time often contribute to recurring foot pain.
When Should I Seek Professional Help For Top Of Foot Pain?
Book an assessment if your top of foot pain:
- Lasts more than a week
- Worsens with walking or running
- Develops swelling, bruising, or numbness/tingling
- Affects your ability to function normally
Early diagnosis and treatment prevents small issues from becoming chronic.
What if my top of foot pain doesn’t improve after a week? Don’t wait, book an appointment with our team today.
What Tests or Treatment Do I Need For Top Of Foot Pain?
At your first physiotherapy appointment, we’ll:
- Ask questions about when and where you feel symptoms
- Watch how your body moves through specific tests
- Review footwear, training load, and daily habits
- Check nerve tension and joint mechanics
- Review your posture and activity habits
We might also recommend follow-up with your doctor if we suspect a systemic condition.
Common Physiotherapy Treatments for Top of Foot Pain
Physiotherapy focuses on finding the underlying cause of your foot pain—not just easing the symptoms. Depending on whether your pain is caused by tendon irritation, nerve compression, or joint stiffness, your physiotherapist might use a combination of the following treatments:
- Manual Therapy
- Myofascial Release
- Joint Mobilization
- Ultrasound
- Shockwave Therapy
- Gait and footwear assessment
- Taping or bracing
- Dry needling (IMS) or Acupuncture
- Targeted strengthening and mobility exercises help restore stability and prevent recurrence
What Stretches and Exercises Help with Top of Foot Pain?
Stretching and strengthening can go a long way in relieving pain and preventing flare-ups. Here are some gentle, physio-approved options:
1. Toe Extension Stretch
- Sit comfortably and cross one leg over the other.
- Gently pull your toes down and away from your shin until you feel a stretch across the top of your foot.
- You can also kneel and sit on your heels with your toes pointing away from your shins
- Hold for 30 seconds and repeat 3 times per foot.
💡 Physio Tip: Do this stretch after activity or when your feet feel tight.
2. Calf Stretch
Tight calves can increase tension throughout the ankle and foot.
- Stand facing a wall with both hands on the wall and one leg behind the other.
- Keep the back leg straight and keep your heel flat on the floor (the front leg can be bent). Lean your body towards the wall until you feel a stretch in your back calf.
- Another easy stretch for your calf is to stand on the edge of a step with your heels hanging off the edge of the step, relax and you should feel a stretch in the back of your lower leg.
- Hold 30 seconds and repeat three times per leg.
3. Foot Lift (Toe Raise)
- While seated and feet flat on the floor, lift your toes and the top of your foot toward your shin, keeping your heel on the ground.
- Slowly lower back down.
- Do 10–15 reps, 2–3 sets.
- A progression would be to either place a weight on top of your foot and lift your foot towards your shin or do the same activity while standing.
This strengthens the extensor tendons that run along the top of your foot.
4. Towel Scrunches
- Place a towel flat under your foot on a slippery surface such as tile or hardwood flooring.
- Keeping your heel on the floor, use your toes to scrunch and pull the towel under your foot. Perform until you reach the end of the towel.
- Once the end of the towel has been reached, using your toes, reverse the previous movement and push the towel away and out from under your foot.
- Repeat 3-5 times.
This helps improve arch control and intrinsic foot strength.
5. Marble Pick-Ups or Toe Spreads
Picking up small objects or spreading your toes apart strengthens the small stabilizing muscles of the foot and can improve flexibility and balance.
Get Expert Advice About Your Foot Pain
Top of foot pain is common but manageable. Whether it’s tendon irritation, nerve compression, or a stress fracture, identifying the cause is the first step toward relief.
A physiotherapist can help you find the source of the pain, improve mobility, and get you back on your feet—literally.