pain in the top of my feet

by Vicki
(Montrose, Colorado)

I have so much pain the top of my feet, sometimes I can't walk at all - even to get to the bathroom! I am overweight and I am working on it. I know if I lose weight it will help, but is there anything else I can do? I have a big garden, flower gardens, grandchildren, etc. and have a busy life. It is hard to have to get off my feet for two or three days at a time because of the pain. Thanks!

RESPONSE

Hi Vicki,

It is impossible for me to make a diagnosis of your foot pain without the luxury of actually examining you, but I will talk about what generally causes pain on the top of the feet and what you can try in an effort to alleviate the pain.
Although not limited to overweight people is a condition known as a midtarsal fault. This is essentially a collapsing of the arch either due from excess weight, or the natural tendency of a persons arch to collapse or a combination of both.
As the feet "cave in" it creates a jamming effect of the bones in the middle of the top of the foot. This collapsing over time will create bone spurring and arthritic changes in the foot in the area where you are complaining about pain.
Because there is a superficial nerve that passes down the top of the foot, at times that nerve will get caught between the shoe and the bone spurring and cause a tingling or burning pain down the foot as well.
The more you are on your feet, the more they will tend to hurt.
Now, if this is the case, the simple answer is to prevent the feet from over collapsing. In doing so you reduce the jamming effect of bone on bone on the top of your foot and the pain for most people will subside substantially.
So how do you stop your feet from collapsing? Through the use of an orthotic.
An orthotic is device that fits in your shoes and supports the arch so that the arch cannot collapse; no collaping equals no pain in midtarsal faults.
I would not recommend you buy an arch support in a drug store or supermarket as the ones I see tend to be all about cushioning and not about actually supporting the feet.
If you are very heavy, the store bought arch supports will be a waste of time and money.
Your best bet would be to try a medical grade off the shelf orthotic like the Super Step orthotics we have on this site.
They are much less expensive than custom supports and for the majority of people, do a terrific job of supporting the foot.
Orthotics work like eyeglasses, meaning they work as long as you wear them. So, if you decide to try them you will pretty much have to wear them from the time you wake up in the morning until you go to sleep. It is the cumulative effect of wearing them that will help your feet.
As stated earlier, midtarsal fault is the most common cause of pain on top of the foot. Another condition that would have to be ruled out would be tendonitis of the tendons on top of your feet. Although this condition can cause pain, it is usually self limiting and at some point in time will go away on its own.
Because you have pain in both feet I do not think you have a stress fracture, but that too would be a consideration in your pain.
Losing weight of course will help, but in a condition like midtarsal fault it will probably not eliminate the pain.

Marc Mitnick DPM
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