Pain When Flexing or Pressing the Top of the Foot: Causes and Solutions

Pain occurs when the dorsum of the foot is tapped or pressed?

Pain is felt in the middle of the prominent tendon on the base of the left big toe when flexing the foot or applying pressure.
This has been ongoing for some time, and there are no issues with the right foot.
The individual is currently in school, has a normal BMI, is not overweight, and does not remain sedentary all day.

LHJ, 10~19 year old female. Ask Date: 2023/02/25

Dr. Chen Yongxue reply Orthopedics

It is likely tendonitis.
Please visit the fracture clinic for an examination.
Thank you.

Reply Date: 2023/02/25

More Info

Experiencing pain when flexing or pressing the top of the foot can be concerning, especially for someone who is still in school and likely active. The pain you describe, particularly around the area where the big toe connects to the foot, could be attributed to several potential causes.
One common reason for pain in this area is tendonitis, which is inflammation of the tendons that connect muscles to bones. The extensor tendons, which run along the top of the foot and are responsible for lifting the toes, can become irritated due to overuse or strain. This can happen even in individuals who are not overweight or who maintain a generally active lifestyle. Activities that involve repetitive motion, such as running or jumping, can lead to this condition.

Another possibility is a condition known as "metatarsalgia," which refers to pain in the ball of the foot. This can occur due to improper footwear, high-impact activities, or even structural issues in the foot, such as flat feet or high arches. If the pain is localized to the area around the big toe, it could also be related to a bunion or a neuroma, which is a thickening of the tissue around a nerve in the foot.

Additionally, if you are experiencing pain when pressing on the top of your foot, it could also indicate a stress fracture, especially if there has been an increase in physical activity or if you have recently changed your footwear. Stress fractures are tiny cracks in the bone that can develop from repetitive force or overuse.

Given that you mentioned the pain has been ongoing for a while, it would be wise to take some proactive steps. Here are some recommendations:
1. Rest and Ice: Allow your foot to rest and apply ice to the affected area to reduce inflammation. Avoid activities that exacerbate the pain.

2. Footwear: Ensure that you are wearing supportive shoes that fit well. Avoid high heels or shoes that do not provide adequate support.

3. Stretching and Strengthening: Engage in gentle stretching exercises for the foot and ankle. Strengthening exercises can also help improve the stability of the foot.

4. Orthotics: Consider using over-the-counter arch supports or custom orthotics, especially if you have flat feet or high arches. These can help distribute pressure more evenly across your foot.

5. Consult a Specialist: If the pain persists or worsens, it would be advisable to consult a healthcare professional, such as a podiatrist or orthopedic specialist. They can perform a thorough examination, possibly including imaging studies, to determine the exact cause of your pain and recommend appropriate treatment.

In summary, while there are several potential causes for the pain you are experiencing when flexing or pressing the top of your foot, it is essential to listen to your body and take steps to address the issue. Early intervention can often prevent more serious complications and help you return to your normal activities without discomfort.

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