Top of the Foot Pain:
The Bone Spur On Top Of Foot [Causes, Symptoms & Best Treatment]
Do You Have A Bone Spur On Top Of Foot? The #1 cause is osteoarthritis and poor bio-mechanics. STOP living in pain, make this pain GO AWAY NOW!
The most common causes of top of the foot pain:
- Top of the foot nerve compression.
- Lisfranc fracture or sprain.
- Sprained top of the foot.
- Top of the foot bone spur.
- Dorsal foot compression syndrome.
- Flat foot compression leading to osteoarthritis.
So, let’s look at the PICTURES!
What Is A Top Of The Foot Bone Spur?
A bone spur on top of the foot forms due to abnormal friction and stress on the bone.
- As the bones of the mid-foot rub against each other, the bone re-enforces itself over many years. This is the development of osteoarthritis.
- This is similar to a callus forming in a high pressure area in response to rubbing on the bottom of your foot.
- The same thing will happen to the bone on the top of your foot with extended jamming and pressure of the joint.
- A top of the foot bone spur is very common, especially in someone with a very high arched foot. This higher arch can lead to more frequent jamming in the mid-foot and rubbing against the top of your shoe.
Overview of The Best Treatment Options:
- Keep reading this very, very loooooong guide for more details.
- But your foot flattening out is the primary cause of your developing bone spurs.
- Great shoes and great orthotics are the best way to stop your pain.
- The spur only goes away with surgery, but orthotics can get rid of 90%+ of your pain!
Instant Pain Relief Options For Pain:
- We love both ice and biofreeze for instant pain relief.
- Studies show menthol based creams like biofreeze can work 2x as long as ice in pain relief.
- These are safer than medications.
- A great pair of shoes will help significantly for midfoot and top of the foot pain.
- These will support your foot from having to flatten out and have pain.
Recommended Full Length Orthotics:
- Full length orthotics prevent your foot from flattening out.
- The downside is they take up the most room in your shoe!
Recommended Dress Shoe Orthotics:
- Dress shoes need a different type of orthotic to relieve your pain and fit!
- These sacrifice correction to actually fit into your shoe!
Recommended Tight Shoe Orthotics:
- Flats, heels and women’s shoes need a different type of orthotic.
- Make sure these fit in your shoe!
- The most common symptoms:
- Numbness, burning or tingling due to nerve irritation.
- Swelling and redness.
- A big bump or lump in the midfoot under the skin.
- It can lead to top of the foot numbness, burning and tingling, these types of symptoms can usually present in the middle of the night when your brain isn’t really focusing on many other things.
- This type of night time pain can occur due to nerve compression at the top of the foot.
The causes of bone spurs on top of the foot are almost always osteoarthritis. This is the buildup of bone due to chronic overuse and poor biomechanics to the foot and surrounding areas.
- Bone does not grow naturally on top of your foot.
- It is usually a response to irritation or friction.
- As mentioned above, it is a sign or arthritis.
- The most common cause is dorsal compression syndrome.
- This is when the top of the foot compresses through the bone.
- As the top of the foot compresses, the bottom of the foot stretches out.
- Other caues include degenerative joint disease or arthritis.
Where else can bone spurs on the foot develop?
Bone Spurs are not limited to feet, although they are mostly found on the feet. Check out the links below to find more information about bone spurs in various locations.
Heel spurs at the bottom of the foot or the heel bone are the most common type of foot spurs. This is associated with a condition called plantar fasciitis. Planter fasciitis is a biomechanical condition and the spur is almost a carrying out of the bone, this takes many years to develop.
Heel spur at the back of the heel is due to that point of the Achilles tendon. Chronic Achilles tendinitis can lead to significant pulling of the back of the heel bone, just like the heel spur on the bottom of the foot this can take many years to develop.
The calcaneal heel spur is also due to the plantar fascia, this is very similar to a heel spur on the bottom of the foot. The actual spur is generally not the problem, but the constant pressure on the plantar fascia is really the issue. If you can fix your planter fasciitis, your calcaneal heel spur should not be a problem.
A big toe joint spur is due to a condition called hallux rigidus. Hallux rigidus is arthritis of the big toe joint. There are many hallux rigidness treatments available, these usually do not require surgery. But the only true way to get rid of this bird is to perform surgery. We have had really good success correcting this with specific type of inserts, taping patterns and specific types of shoes.
Ankle bone spurs are due to ankle arthritis, this is also a biomechanical problem that takes many years to develop. With ankle arthroscopy you can do breed these and give your ankle numerous years of good ankle joint function. The real key is working on biomechanics, assessing where you have muscle dysfunction, and correcting this with good orthotics and good shoe gear choices.
Outside of the foot bone spurs are frequently due to pain on the outside of the foot. There are a few different biomechanical issues that can cause this. Read our guide on outside of the foot bone spurs and pain to learn more about this.
A Bone Spur on Top of the Big Toe:
- A bone spur on top of the big toe is known as hallux rigidus.
- This is osteoarthritis of the big toe joint.
- Osteoarthritis of the big toe is something that takes numerous years to develop.
Why Do Bone Spurs Develop on Top of The Big Toe?
- As your foot begins to flatten out, it begins to jam improperly.
- It’s almost like thousands of microscopic little cracks develop within the joint.
- As this starts to crack, and your bone starts to attempt to heal itself, but this eventually leads to thicker and more rigid bone.
- This is usually something that takes many many years to develop, and we see in people who work or stand on their feet almost all day long.
How is This Different Than A Bunion?
- This is much different than a bunion, this is the jamming of the big toe joint until you develop significant trauma to the site.
- The bunion is more like a dislocation of the joint, where as hallux prejudice and a bone spur is more arthritis of the joint.
- If you think of your joint as a Teflon frying pan, just pretend that the missing cartilage is like your frying pan missing the Teflon coating.
Bone Spur on Top of the Big Toe Treatment:
- Another name for a bone spur on top of the big toe is known as treatment of hallux rigidus.
- There are conservative treatment options which prevent surgery.
- Then there is surgery to actually remove the spur.
- We have had tremendous success healing this issue with orthotics, taping, certain types of shoe and foot modifications. It is not unusual to get at least 50% pain relief by simply switching to a good shoe, and getting 75 or more percent relief further with good orthotics within your shoe.
- Surgery is an option to remove the spur to the top of the big toe joint.
- This is traditionally a very successful surgery as no implants or screws ever need to be placed.
- It is simply a small cut that is made on top of the big toe joint and with specialized equipment we can trim down this extra bone spur.
- Although this is considered more minor foot surgery, there are still extensive risks to any foot surgery that you would undergo.
- So, do not enter into any type of surgery lightly.
- There are many treatment guides and they are explained best in this treatment video.
A Bone Spur On Top of The Foot:
- This type of bone spur develops in the middle of the foot.
- This is a joint called the Lisfranc joint.
- This is also from your foot flattening out and causing pain, cartilage damage and eventually arthritis.
Bone Spur on Top of Foot Treatment:
- There are two major treatments for bone spurs on top of the foot.
- There is the natural remedies that do not involve surgery and the surgery treatment options.
- Both are good solutions with pros and cons.
Bone Spur on Top of the Foot Natural Remedies:
- There are many different natural remedies for a bone spur on top of the foot.
- Read below for the Pros vs. Cons.
Natural Remedy Pros:
- No surgery is needed.
- These are always worth trying before starting down a surgery treatment pathway. Just make sure you are comfortable with the actual bump never disappear, but the pain will disappear.
- There are many ways to treat or fix a bone spur on top of foot.
- Even if natural remedies do not fix all of your pain, at least a portion of it usually does go away.
Natural Remedy Cons:
- They will improve your pain level, but the spur will never go away.
- The spur is a bone growth at the end of the day and short of significant osteoporosis this will never go away.
- These routes can be expensive and do involve orthotics and the proper shoes.
- These treatments are not fully guaranteed to work.
How to Treat or Fix a Bone Spur on Top of Foot Without Surgery:
The initial goal of treatment is to decrease the inflammation:
- This over time will decrease the numbness, burning and tingling.
- Top of foot numbness is due to a condition called neuropraxia.
- As there is irritation around the nerve, it stops working properly.
- But if the inflammation is removed, it will function again normally very soon.
Treatment will focus on control of inflammation:
1)Rest, Ice, Compression & Elevation of the foot.
- This will simply calm down the inflammation of the foot. This is more to feel better, not a permanent solution to the problem.
2)Oral anti-inflammatory medication.
- NSAIDs like aspirin or Ibuprofen can help decrease the more significant pain. You do not want to do this permanently, this is more of a temporary solution.
- While oral anti-inflammatories are successful in the short term, you do not want to make this something that your eye on for the rest of your life. Medications are not meant to fix a problem, but simply get you through the more painful state while you are able to find a more permanent solution.
3)Topical anti-inflammatory medication.
- This is like the oral anti-inflammatory. These are gels like Voltaren gel or Biofreeze gel. These can really help in the short term making your foot feel better.
- Just like the oral medications, topical medications are not meant to be a lifelong treatment. While these are a good option in the short term and the side effects are a little bit less, this is still a hassle to have to put this on very regularly. The real key to solving these are good biomechanical corrections like orthotics and shoe gear.
4) Better fitting and very supportive shoes.
- A good rigid and supportive shoe like a running shoe can really help.
- This is the single biggest issue that can be corrected.
- Many patients that we see, simply wearing a good supportive shoe at work or a good supportive shoe at home will make all your pain go away.
- Consider shoe brands like Asiics, Brooks, Saucony, New Balance, Hoka or even now brands like Sketchers can be very good.
5)Orthotics to control the foot structure the induced the improper foot structure.
- A good supportive over the counter orthotic can really help.
- Orthotics for a bone spur on the top of the foot greatly realign the bone structure of your foot.
- The real goal of orthotics is to take the pressure off your bones in your joints, which lead to arthritis. The goal is then to switch this pressure on to your muscles which rather than getting arthritis, they simply get stronger and more powerful.
- Orthotics strive to give you a good healthy functional foot without taking any medications or getting any surgery.
6)Lacing pattern as seen above.
- Skip the laces in the middle of the shoe.
- If the problem is simply the top of the shoe pressing against the top of the foot, this is something to consider.
- Skipping having compressive laces over the bone spur is the single most effective thing that we can do for you in the short term.
- Some people develop the pain from having pain within the joint, but some people develop the pain from having their shoelace rubbing against the top of the big spur that development because of the joint pain.
- This is a confusing concept to imagine sometimes, but the rubbing on top of the joint is more of a symptom of extremely long term rubbing within the joint.
- By avoiding the leases covering this bone spur, it takes pressure off the superficial peroneal nerve which can become compressed between the skin and the bone spur underneath it.
Bone Spur on Top of Foot from Running:
- A bone spur on top of the foot from running is mainly irrated because your foot becomes more aggravated during running.
- The amount of force your foot absorbs increases greatly, so it is more important to have great shoes and orthotics while running.
- Another option is that there are better ways to exercise rather than pounding your feet into the ground thousands of times.
- Especially if you are not in the greatest shape in the world.
- Consider swimming and cycling as great alternatives.
Do These Spurs Ever Go Away?
A heel spur will never go away without surgery, but the pain can be removed!
- Once bone is formed it is there to stay unless you consider surgery.
- It is useless to try and remove the bone without performing surgery, but a good idea to try and decease the inflammation and preventing the pain that it is causing.
- Surgery for a top of the foot bone spur is very common.
- It is a procedure where a small incision is made on the top of the foot, then the bone is shaved off.
- The pain caused by the spur can be controlled.
- If it compresses nerves or causes tendonitis, this can be drastically decreased.
- Different ways of tying your shoes can drastically decrease the pain.
Treatment that works: Bone Spur Surgery:
To permanently remove the bone spur, surgery will be necessary.
- It may also be necessary to correct the improper biomechanics that led to the formation of the joint spur.
- You should always try the non-surgery treatments first without question, they won’t remove the spur, but your pain will feel better.
- Surgery can be minimal, but every surgery is generally considered a risk.
- This is not something that you should take lightly, every surgery has associated risk factors.
- Minimal incision are used and you should not have to be off your feet too long, although sutures generally stay in for 2 weeks.
- You will likely be bandaged and in a boot for a couple weeks, then in a surgical shoe for a few more weeks.
- Stitches usually come out in about 2 weeks.
- There are more permanent solutions to a bone spur on top of your foot.
How Long is Bone Spur on Top of Foot Surgery Recovery Time:
Bone spur on top of the foot surgery recovery time is usually the time it takes to heal the incision site. Specifically it can take 2-3 weeks until sutures are removed. Most patients experience a recovery time of 2 weeks in a dressing and surgical shoe. They can then transition to a very comfortable surgical shoe for 3-4 weeks after this. Your foot may continue to be very sore for 6-8 weeks total until you can start to resume completely normal function.
Bone Spur Removal Surgery Recovery Time:
- 2-3 weeks until suture removal, this includes wearing a dressing.
- You are able to walk in a surgical shoe, but with more aggressive walking you will experience soreness.
- At 3-4 weeks you will be best served wearing a big band aid over your foot, this will protect your incision site.
- At approximately 6-8 weeks you can resume full function such as running and heavy duty lifting.
- If you can only take 1 week off after surgery before needing to resume long work shifts, this surgery may not be for you.
Bone Spur on Top of the Foot Surgery Recovery Time Protocol:
This guide will detail the length of specific step by step bone spur surgery recovery time.
Day 1: Top of the Foot Spur Removal Surgery Day:
- The actually surgery takes well under an hour, and your foot is usually numbed up for the rest of the day.
- Some people don’t need much if any pain medication outside of anti-inflammatories. If you do have pain to this site, then it is normal to have a prescription for a narcotic pain medication for the days immediately after the surgery.
- After surgery you will wake up with a dressing on your foot. Keep this dressing in place and your pain will be well under control with medication.
- No implants or bone healing is necessary, except for the healing of bone pain.
- You can wear a boot over your dressing almost immediately.
- Most physically able people do not need crutches or a walker unless they have other health issues.
- Usually there are about 2 sutures in the foot.
Day 7: Top of the Foot Bone Spur Removal Surgery Postoperative Visit #1:
- Within about a week, we have the first postoperative visit.
- You will have an X-ray at this visit and we will make sure there is no irritation or damage to your dressing.
- With this dressing change some antibiotic ointment is applied, we make sure you are not having any problems at this time.
- Sutures are not removed yet at this visit.
Week 2-3: Top of the Foot Bone Spur Removal Surgery Postoperative Visit #2:
- This can fluctuate depending your overall health needs, physical fitness and life needs.
- If you are able to rest more, weight less and are really healthy, sutures can usually come out at 2 weeks. Some patients need to walk and be more active, if this is the case you will likely need sutures longer and have a larger dressing.
- If you swell more and are more tender, they can stay in a little bit longer.
- If you are a smoker or have decreased healing ability, we may need to keep your sutures in place longer.
- At this point your incision site should be healed.
- At this point you will wear a band-aid for 2 weeks and walk in a good supportive running shoe.
Week 5: Postoperative Visit #3:
- This is what the incision site will look like after the sutures are removed at 2-3 weeks or so.
- If everything looks good, you no longer need to wear a band-aid.
- At this point you will still be sore but can transition back into
2 Months: Postoperative Visit #4:
- At this point you continue wearing a good supportive orthotic and good shoe.
- If everything is feeling well you should be close to healed.
- Keep in mind that you will continue improving for about 6 months total. But at this point you should be feeling better than you did prior to when you have a heel spur.
- Congratulations you
Get A Great Shoe:
- The first step is to get a good supportive running shoe, if you have any questions with this comes your podiatrist or get something that you would feel comfortable running a marathon in.
- Take a look at what people are running marathons and, it’s not a decked out signature Nike or Under Armor shoe!
- The first thing you need to do is look at your shoes: most patients that we see think they are wearing great shoes, but they can actually be terrible shoes.
- In today’s world of marketing, commercials make it seem like a shoe is great for you, it can actually be a terrible shoe! We see hard-working and well-intentioned athletes come in with terrible unsupported and flimsy shoes. This is even the case if you buy $200 plus shoes!
The Best Orthotics:
- This is very cheap investment to get rid of your foot pain.
- There are much cheaper over-the-counter custom options available as well.
- Do your best to avoid the flimsy gel pads.
- These are our recommended orthotics:
- This is not something that we would recommend doing at home, but a doctor can help you with this.
- If you do have severe pain that is really preventing you from doing anything, this may be an option in the right circumstances.
- Anti-inflammatory medications could be good, but we do not recommend this as a long-term solution.
- Focus on the orthotics in the shoes.
When is surgery a good option? Probably only 10% of the time!
- If you have tried all the above stuff, and a couple months have gone by and you have not started to improve at all, then further and imaging like an ultrasound, x-ray or MRI might make sense.
- If you have long-term permanent damage to the top of the foot, especially if it has been going on for over 6 to 12 months, then you may need surgery.
- Top of the foot surgery has its benefits, but any type of surgery may have its negatives.
- Make sure to check with a podiatrist to see if you qualify. You may be one of the 10% for whom it may be a great idea!
Top of the Foot Home Treatment:
- There are usually two phases to treating top of the foot pain treatment.
- This doesn’t matter whether it’s intermittent sharp pain on top of foot, pain on top of foot near toes, tendonitis on top of foot or a top of the foot bone spur . Treatment is all roughly very similar.
- The two phases of treatment include controlling the acute inflammation, and correcting the biomechanics which led to the problem in the first place.
- Great top of the foot shoes and great orthotics lead to the prevention of dorsal compression syndrome. This prevents the compression on top of the foot, it prevents the stretching on the bottom of the foot.
- This will also reduce your numbness, burning and tingling pain.
Massage & Ice Products:
- The metal ball is one of my personal favorites.
- This can work well for a bruised top of foot.
- This is not a permanent solution, you still need to remove the stress off of the top of the foot.
Menthol Based Gels:
- Biofreeze is one of our favorites.
- These gels have been studied to work 2x as long as ice.
- This can also work as a great option for a bruised top of foot or top of the foot extensor tendonitis.
- This is not a permanent solution, you still need to remove the stress off of the top of the foot.
- These can work great for loosening your muscles.
- This allows less tightness and pressure on the ball of your foot.
- This works best for extensor tendonitis on the top of the foot.
Removing The Stress:
- The key is to prevent future pain.
- If you can get rid of the pain and swelling, this will let you start walking normally.
- If you can walk normally, the vast majority of your pain should gradually start to go away.
- This will limit dorsal compression syndrome and limit extensor tendonitis to the top of the foot.
Best Top of the Foot Pain Shoes:
- Getting a great supportive pair of shoes will make sure that there is pressure removed from the top of the foot.
- There is much less compression appreciated.
- This is especially important if you have a swollen top of foot, intermittent sharp pain on top of foot and top of the foot compression.
- Consider shoes combined with a good supportive orthotic for best pain relief!
- The following link will show you what our favorites are.
The Best Top of the Foot Pain Orthotics:
- These are our recommended orthotics.
- There are different types for different shoes.
- Women’s shoes usually need a less bulky orthotic, but allow for less correction.
- A full length orthotic requires a running shoe, boot or comfortable walking/dress shoe.
Best Full Length Orthotics:
Best Dress Shoe Orthotics:
Best 3/4 Length Orthotics:
Get A Great Dynamic Stretch:
- It is possible to stretch on your own, but these products can also really help!
- This will take pressure off of the ball of your foot.
Get A Great Static Stretch:
- These devices are great for stretching while you are resting.
- This will also help take pressure off of the ball of your foot.
Top of the Foot Pain Trauma:
- If you have a sprain Of the foot, Lisfranc fracture, or a fracture to the top of the foot, the need to protect it.
- The recommended way of doing this is to offload with a good supportive boot or cast.
- The best way to do this is of course to see your podiatrist and get evaluated with an x-ray, ultrasound and potentially even an MRI or CT scan.
- If you are unable to do so it may benefit you to be in a cast, fractured boot, or even keep the weight off of it with a rolling knee scooter or other protective devices.
- We as podiatrists frequently take patients off work for very long period of time when they suffer a traumatic injury, unfortunately there is no other way around us in labor jobs.
- If you have a sit down job there are ways to get people back to work quicker, but this can be very difficult otherwise.
Top of the Foot Fracture Boot Treatment:
- There are pros and cons to using a boot to treat your foot pain. If you are immobilized too long the cons are that you will gradually become stiff and overworked to your other leg. The pros are that you injured heel will hopefully have a chance to gradually heal!
- Our favorite fracture boots and their supplies:
Offloading and Scooter treatment:
- These are favorite knee scooters and walking devices.
- If your Achilles tendonitis pain is severe, offloading it can be very effective until the pain calms down.
Top of the Foot Pain: