Pain on Top of Your Foot: Stress Fracture or Extensor Tendonitis?

Our feet are more than just bone and muscle; they’re also comprised of ligaments and tendons, which carry the full weight of our bodies every day. So it’s not a surprise that many people experience foot pain in some capacity. A frequent cause for complaint is pain on top of the foot, which can occur when walking, running, or even when sitting still.

What Would Cause Pain on the Top of Your Foot?

Two of the most common causes of pain on top of your foot are extensor tendonitis and stress fractures. The similarities between these conditions can make it difficult to know which you have, and until you know what you are dealing with, you cannot properly treat it. Fortunately, there are differences you can use to determine what is causing your pain.

Extensor Tendonitis on Top of

Extensor tendons are tendons in your hands and feet that play an important role in their movements. People who spend a lot of time on their feet may develop extensor tendonitis of the foot, which is an inflammation of the extensor tendons. Wearing shoes that are too tight can increase your risk of developing the condition as well.

The most common symptom of extensor tendonitis is pain on the top of the foot often at the midpoint of the foot bones. Extensor tendonitis symptoms can develop in both feet, but in many cases, only one foot is affected. The pain produced by the condition tends to increase gradually as the tendon becomes more inflamed, and it may be relieved somewhat by activity, which stretches the tendon in the foot.

Stress Fracture on Top of the Foot

A foot stress fracture, also called a hairline foot fracture, is a tiny crack in a bone. It’s typically caused by repetitive use and overuse. Runners and people like military recruits and hikers who carry heavy backpacks over long distances are especially susceptible to foot stress fractures.

You can often detect a stress fracture in your foot because the pain from a stress fracture is typically associated with a specific spot and may be minor at first, increasing over time. It tends to worsen with weight-bearing activities and lessen with rest. There may be swelling, bruising and tenderness in the area near the fracture.

Stress fractures typically cause pain in different areas of the foot. Signs of a stress fracture on top of the foot are pain on top of the foot, but often the fracture will also produce pain that is felt more deeply within the foot or toes. This is one of the primary differences between extensor tendonitis and stress fractures.

In general, when you have a stress fracture, foot symptoms include:

• Pain during typical daily activities
• Swelling of the foot
• Pain that lessens when you rest
• Tenderness
• Bruising

While having a stress fracture in the foot doesn’t mean you have to completely avoid walking or bearing weight on it, you’ll need to minimize your activity while the bone heals.

How Do You Detect and Treat Extensor Tendonitis and Stress Fractures in the Foot?

You can detect extensor tendonitis of the foot or a foot stress fracture, and tell them apart, based on the pain. If it subsides somewhat with activity and gets worse when you rest, it’s more likely to be extensor tendonitis. If your foot hurts more when you’re bearing weight on it and feels better when you rest, a stress fracture is more likely the cause.

How Do You Relieve Pain on the Top of Your Foot?

Extensor tendonitis and foot stress fractures can heal on their own. However, the following treatment options may help accelerate the process and relieve some of the pain on top of your foot.

How to Heal Extensor Tendonitis on Top of the Foot

To treat extensor tendonitis symptoms in the foot, do the following:

• Ice the area of the foot for 20 minutes at a time to help reduce the swelling.
• Take a nonsteroidal anti-inflammatory drugs (NSAID) for foot pain relief.
• Stretch your calf muscles, as tight calves put more strain on the extensor tendons.
• In some cases, physical therapy may be needed to improve the condition.

How to Heal a Stress Fracture on Top of the Foot

To treat a foot stress fracture, follow what’s called the RICE method:

• Rest (and minimize weight-bearing)
• Ice (the affected area of the foot)
• Compression (wrap the foot to minimize swelling, being sure you don’t inhibit blood circulation)
• Elevation (spend time with your foot above the level of your heart to reduce swelling)

You can also use NSAIDs for foot pain relief.

With either condition, if it gets worse or doesn’t improve with time and treatment, talk with your doctor. You should never try to “push through” an injury as that can lead to more damage and a longer recovery period.

Learn More About Relieving Pain on Top of Your Foot with Baptist Health

If you’re experiencing pain on top of your foot, contact the Baptist Health Orthopedic team today to schedule an appointment.

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