Foot bump on top of the foot
Welcome to my foot pain series
The foot bump on top of the foot is a problem many suffer and accounts for the top hit on my website for two years running. This article was written after one of my regular readers asked for information about her foot bump. I decided to check out what readers might find on the internet. As usual, U.S YouTube videos top the polls with information while the traditional UK sources were disappointing. However, how good is the YouTube material? For readers wanting academic resources more can be found at the bottom of this article, and why not read the slightly more academic article tarsal boss foot bump.
- a Google search for what people have said
- formal critique of the advice given
- the cause (aetiology -Br. etiology – US)
- some of the features that are involved with the condition
- how you can help yourself and a few pointers about surgery
- evidence
You can also check out other foot bumps on ConsultingFootPain Bump on the side of the foot (navicular bone) and the heel bone bump or ‘pump bump‘.
The condition
the foot bump is on top of the foot
A condition that causes pressure on top of the foot due to changes around the middle bones, also known as the tarsus. Conditions associated with the bump include joint surface damage (arthrosis). Tendon or nerve pain that arises with the hard bone bump. Look at the picture of a female foot to identify the problem (source: Bawa 2016). Naming the condition Other names given to this condition are dorsal spur, exostosis, and tarsal boss. This latter term is quite apt as in the Collins dictionary boss can mean a knob or stud or other circular rounded protuberance.
Checking out what has been written on the internet
Lump on top of your foot? If you’ve noticed a lump on the top of your foot, you most likely did a quick assessment, perhaps considering such questions as:
- Is it painful?
- Is it soft or hard?
- Is it a different colour than other foot skin?
- Have you had a recent injury to the area?
We do need to look at hard and soft. The colour of the skin can also help. If very red and inflamed, the body is reacting to the site. If pain increases or is not helped by painkillers, seek help. If you have had an injury ask a professional for help. Looking at Google again this statement is true but does not mean you have arthritis which is a medical condition. You may have elements of what we now call arthrosis; wear and tear only and it can be quite minor, but there is inflammation present. Bone spurs can occur in any bone, but they’re most common in the joints. They’re often caused by joint damage associated with osteoarthritis. Damage is caused by stress or pressure placed on a bone for a long time. Google search came up with the following. I liked the short punchy statements but removed some material irrelevant to the subject title.
A typical question from a layperson (edited)
(Qu. 1) ‘I have a small pain in the top of my foot just below my toes. I get a sharp pain in the centre of the foot, that is well I can’t move for just a matter of seconds. It happens if I move my foot wrong, but I’m not sure how to explain that. It feels like being punched. The pain in the right foot, makes walking uncomfortable, however especially now that the weather has gotten warmer I will be doing more walking. I walked last night for over an hour. My foot is sore today, however I still can get up and walk around my office as needed. Any suggestions or thoughts. Thank you so much.’
(Ans.1) ‘You could try icing it when it bothers you. Maybe go to a massage therapist.’
(Ans.2) ‘I have one too! Sometimes, if it gets bothered by a shoe or too much walking, I just spend some time off the foot or put some ice on it. Hope that helps!’
(Ans.3) ‘There is not a lot that can be done for this non surgically, as it is a bony mass. Try wearing loose fitting shoes as tight shoes would tend to aggravate it. Also consider placing a pad on top of the deformity to help reduce stress and strain on the area with the compression that causes the irritation of the nerve.’
An online medical doctor (US) also responds, so this must be good.
‘Hello, make sure the shoes are wide in the toe and have good heal support. Use Spenco insoles which you can get in any shoe store. These are ultra thin but absorb over 90% of any impact. This might or might not be just in the feet, so when you can afford it you need to see a podiatrist or a physical medicine and rehabilitation specialist to see where the actual focus of strain is…I prefer the later because even a lower spine problem can affect the feet and cause pain. And vica versa.
On line can be helpful but it is difficult of genuine help actually fails to understand the problem.’
Feedback
Good or bad advice? Well the information while helpful can be misleading but there are some good bits worth highlighting
The patient
The person writing in gives us a hint. Sharp pain with shoes. Foot movement causes discomfort, and the pain level is described as ‘punched’. Walking is uncomfortable and sore and she is likely to use the foot more as it becomes warmer. One key piece of evidence could relate to a nerve that is irritated. The pain is momentary and stops her from moving. What of advice 1? Ice is always helpful but will only settle discomfort due to inflammation if it is minor. If it is nerve pain, ice will play a minor role.
The answers
Answer 2. About the same and the idea of reducing walking is only a temporary measure. Answer 3 sounds more intuitive. Footwear loosening is good and I like the pad. So it’s time to look out for a YouTube video. Oops, there aren’t any! YouTube is full of promoting practice visits; you don’t want to do this unless you need to. The person giving answer 3 believes that sometimes surgery is required. This is true but getting that diagnosis right is vital. But what about the doctor? He must know as he is a medical doctor. It is okay to talk about shoes and make them wide. That sounds fair advice, but why not focus on the design of the top of the shoe?
This is where the problem lies ‘…Use Spenco insoles which you can get in any shoe store. These are ultra-thin but absorb over 90% of any impact...’Oh dear someone does not understand the problem. Put an insole in the shoe, even if it is ultra-thin and you will make the shoe tight and the bump will hurt more! Okay, if in doubt avoid the question entirely doctor, but I like your advice about seeing a podiatrist. Hey now why chuck spine in there, that is scare mongering!
Conclusion
Sometimes medical doctors do not know as much about feet as you think. It’s true as many of my GP doctor friends admit this. Online advice can be helpful but it is difficult where that help, even if well-meaning fails to address the problem. Some of the lay ideas on the other hand were reasonable. Patient’s own experiences or journeys can be enlightening and deal with practical solutions.
Heredity
Some people have the bump; others do not so there is a hereditary feature in its appearance. My mother and I do not have one; my father and sister do. My wife does not have one but one daughter does. The first anyone knows about the bump is from a shoe which inevitably rubs. Some consider the bump due to a high arch foot, but this is not an exclusive club. Some consider that at one point there is movement during walking of the two bones that are involved in the joint. Whatever happens, bone spurs stick up and can irritate a nerve, or the skin becomes red and sore. A small sac of fluid (bursa) can form and this is often called a ganglion. A balloon-like an appearance arises when pressed and feels spongy.
Use a bible?
Some say hit it with a bible; this would NOT BE a good idea. Hitting the foot may cause deep bruising or even a bone fracture. The idea was to burst the lining so the fluid, which is a clear gel-like substance would be released. The lining of the ganglion is very active and can reform and certainly even if removed can reoccur. However, a bump may not be that simple.
The following conditions can be considered
- Arthrosis, or joint surface damage.
- Tendon pain, often associated with overuse
- Nerve pain
- Ganglion
- Bursa
- Hard bone bump is also known as a spur.
- Gout has been recorded but this is not that common in the midfoot so it can be set at a lower priority.
First of all, look at the appearance. The top of the foot will have a bump above the arch and it can be tender to touch, worse in some shoes. If we look at an x-ray it is easier to see what is happening. Picture: Dr Van Dalen
The main aim is to take away pressure so it comes down to shoe selection and what you can do to the shoe to make matters more comfortable. Remember that the lacings of shoes can be too tight, or the cut of the shoe places a too much pressure where it is tender.
Self-help remedy
Protect the skin from pressure. This was recommended by the layperson’s number 3 answer.
- Use a felt pad with a cavity over the bump and if this works, the pad can be converted so that it sticks onto the skin or inside the shoe under the tongue.
- Select shoes with a lower heel so that the arch does not bend as the joint will open more in high-heel shoes.
- The quarters (where the laces run through the eyelets) should not be closed up too tightly and a cushioned tongue in shoes will be better tolerated (see picture c/o www.footeducation.com)
- You can make your own soft tongue using an adhesive dressing as in a cavity-type pad fashioned from a square felt or foam. See the self-help sheet (click here)
In general, local protection and selection of footwear to avoid pressure over the bump will allow the area to settle. Unfortunately, if you have a shape that will not go away, you will have to compromise. This can be tough for those who like fashion.
Seeking surgery
Not perhaps where you want to go but sometimes surgery is the best way to resolve matters permanently. You should seek out a foot surgeon (podiatric or orthopaedic). Check they are registered with the HCPC or GMC. Here’s a summary of my experience and some things I would tell a patient before surgery.
An operation
- The scar line is important so where the skin is cut can be a problem.
- The bone is shaved down. If you are under 20, reoccurrence can arise because young people can regenerate bone. This might happen more readily if there is greater movement after surgery as it can all start again, or insufficient bone is removed.
- Although bump surgery can be very effective, wounds can take time to heal. You can expect the skin to heal from 10-21 days before it is relatively strong to get back into shoes. Sensations may vary after surgery, numbness or local sensitivity.
- The good news is that the surgery works and it is effective.
- The bad news is that the joint may be less stable and if you have existing degeneration in the joint movement made, making the joint freer may worsen matters. This means a second surgery to stiffen and fix the problem. This does not happen very often.
Stiffening the toe?
This means a screw or metal brace (plate) is placed across the joint. On balance real problems arise from loss of movement around the joint from this procedure.
So why do I need to have it stiffened?
The spur actually holds the joint stable. The two ends might now move as the surgery involves shaving off the spur. After surgery, once the foot has healed, you can try out shoes again. It makes sense to allow up to six months for all shoes. Of course, there might be a pair you still cannot use but on the whole, your comfort and the original problem will have disappeared.
ConsultingFootPain is a website published by Busypencilcase Reflective Communications offering impartial information about foot health problems without promoting products other than resources that might be best suited. English is the main language but information sources may come from worldwide. The opinions expressed in articles are that of the editor while a selection of material is provided that appears equally impartial, direct and likely to be helpful to any reader while attempting to provide a balance of argument. Providing responsible self-help guidance is the guiding principle
Thanks for reading ‘Bump on top of the foot’ by David Tollafield
You can now read Foot Health Myths Facts & Fables by David R Tollafield published on Amazon books
Published by Busypencilcase Reflective Communications Est. 2015
Originally published 2019. Reviewed and modified 19 April 2022
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Why not read – Podiatry as a career choice?
I have this. Both feet affected. They were extremely painful all the time. I put arch supports in my shoes and after about 10 days, when my body got used to them, the pain went away. I can walk for hours if I like. I volunteer for 5 hours a day, standing in retail. No pain at all. I am in my sixties. I hope this is helpful. Editor -There are benefits from orthoses (arch supports) Anne. By using such a device this stabilises movement around the key joints. For some orthoses can push bone bumps into the shoe making the foot more uncomfortable. Sometimes it comes down to a trade-off.
Thanks. Ignites hope. Have Tarsal Bumps in both.
Would appreciate if a ball park idea of involved costs can be indicated. Best
Anu, your question on cost depends on an accurate diagnosis and what is required. Secondly, you would have to decide who you see, orthopaedics, podiatry or an orthotist, and where you saw that service.
Not sure if what I experience is the same. My bump has been obvious for year however just started about a year ago to be a problem. It is not an everyday problem, the shoes tied tight do make it worse so I try to adjust the shoes to keep no pressure on the bump. Numbness is common for the foot and pain and swelling will be in the arch just below the bump. I walk most days, pain is not each time I walk. I will try icing and hot soak with Epsom Salt. Very concerned about surgery, not considering it as an option if it can be avoided.
Editors note: I agree with Jolene that avoiding surgery is the main thrust but pain and disability require support and a bump could also involve joint pain that needs support beyond self-help. Where surgery is required it can be very successful and make a big difference to people’s lives.
I dropped an object on foot nine months ago. I saw two different podiatrist so far no relief. I was given orthotics it makes my foot even more. No cold or hot compresses help either. Wha now.
Ed. Note: At 9 months you have sustained a much bigger problem and clearly need some investigations. As I don’t know where you live I cannot advise on the type of podiatry but this does not sound like the USA. If you have had x-rays done what were the findings? It is better to write to me at busypencilcasecfp@gmail for more personal discussion.Thanks for posting a comment. I remind everyone writing in that we cannot provide an answer to all questions nor can be second guess conditions with more detail.
I have a bump on the forefoot of my right foot. I had a bunionectomy 10 years ago and I went to the podiatrist about a year ago and he stated it was a bone spur. He stated if it doesn’t bother you consistently, leave it alone. Well, now I’m at the point where it bothers me all the time, no matter what shoes I wear! Even when I am barefoot, it bothers me! The only time it doesn’t bother me is when I am sitting still doing absolutely NOTHING! Well, I can’t live like this! I will be addressing this matter sooner than later!
CFP responds: I agree Lorie this is not a happy state of affairs. To be clear I assume we are talking bump on the side of your foot? This is where the bunion traditionally is but of course bumps can be on top of the foot as well. A bunionectomy is where the bone (spur or projection is shaved). If this reoccurs or pain increases it is because the joint is probably inflamed. One of the problems with treatment, and this includes surgery, is the reality that feet take considerable punishment and symptoms and problems can return after initial treatment – sometimes years later. The sad thing about medicine is that there is no time, or resources to follow every patient intimately and so we rely on each person reporting back. You are justified to return to your original foot surgeon or seek a new surgical opinion which I recommend. The time has come to do something about this foot,
Inserts have really helped my issue which is the same bump. Also foot massager makes a difference.
I have arthritis on both my feet however the left foot is more severe… Also I have bone spurs on the top of the arthritis.
unfortunately there are nerves running over the arthritis in the bone spurs causing what I would say is a very “ electrical“ pain. Cording to the doctor I’m seeing I also have degenerative joints and apparently arthritis has also invaded that part of my foot I have
I have received Cortizone shots in three areas of my foot. Hopefully this will calm down the nerves. Any thoughts on other ways to diminish this painful situation
CRP response: Thanks for your post Barbara. Unfortunately, corticosteroid injections are often temporary and repeat injections work less effectively. Nerves can run close to some structural bumps. Where this arises you do need to ensure footwear does not compress again skin and nerves. In feet trying to deal with arthritis is a question of footwear balance i.e accommodating the additional space, using padding if necessary to cushion the bone spur. Exercise actually helps as often as you can manage. If you have several joints affected then a professionally prescribed orthosis may help walking. Without lots more detail I can only give very general advice. Some folks use chondroitin sulfate tablets to help but there is no absolute scientific proof. Foot spa baths and often valuable and relax nerves and tight foot muscles.
I actually agree with his reply! When you cannot escape pain. With either pain, medication or nerve medication. But I do suggest taking Lyrica which could help you. Outside of that hot water and soaking in a hot bath or soaking your feet.Epson salt, eucalyptus, stuff like that can, calm you down and your focus on the pain. Truly the only way to escape, is escaping mentally. With chronic pain comes depression. Misery loves company. Period
It is always helpful to have folks write in about their experience. In Anthony’s reply there are some suggestions but Lyric or Pregabalin, being a neurogenic medication, does have some significant side effects. It is certainly not a first line treatment. Always go to footwear first as more problems are caused because of poor fit or unsuitable designs for lumps and bumps. Chronic pain may be a side effect and intractable pain – i.e pain that won’t go away, may indeed be suited to the aforementioned medication. This should be presribed by a professional.
Just yesterday I struck the top of my foot on a pole nothing I thought was serious. It didn’t even hurt when it happened. I put on a tennis shoe to go jogging and felt the pressure from the laces. It has gotten steadily worse and I have a lump where the picture showed. No swelling or redness just can’t apply any pressure to it and feel kind and needles I’m scared. I took a naproxen and have ice on it raised but pain is getting worse as the night goes on. Any thoughts?
Ouch, Anne, even though it never hurt at the time.
As you can walk on the foot, it suggests soft tissue damage with the usual swelling features. As the foot swells, even locally, the chances are this will cause pressure from the injury site. The sensations are just the nerve not liking the pressure of the tennis shoe, most likely. I doubt there is cause for alarm.
Use a larger shoe so it does not press for a week. Sandals for this season work ok if you are not exposing the foot to any likely risk. ICE the foot twice daily for 10-15 minutes. It may take a week but probably less for the effect to disappear. A bruise shows local bleeding, a sign of injury. Try repeating the activities after 3-5 days. If there is no improvement within 3-5 days, seek out a podiatrist locally.
I have a firm, slightly movable lump on the top of my metatarsal tendon; I thought it was a bone spur for several months, it never bothered me until I was folding towels with my foot pressed against the ground and I started having horrible nerve pain in that area. I finally got into the podiatrist,who did an X-ray And said he does not think it is bone because it didn’t show up on X-ray. In the meantime I’m awaiting an MRI and super scared! It is very firm call and feels like it is phone. His first option was surgery.
Thank you Amber for your post. I am not sure which tendon you refer to but assume it is along the first metatarsal and the tendon is likely to be an extensor as it crosses the foot. The ‘phone analogy is perhaps like a signal, possibly an electric shock we call paraesthesia. Any nerve compressed can achieve this. The objective is to identify the problem, then protect it and stop the nerve damage from escalating. Footwear selection is vital and avoid activities that create the problem. An MRI is correct as it identifies all the soft tissue around the area, making diagnosis easier. The cheapest test is called Tinnels sign. You tap the point of irritation once and create the effect you describe. The test is highly positive for nerve entrapment. Are you ‘super scared’ of the MRI o surgery? I assume surgery as an MRI does not entail going into a confined space for the foot. Ask to try a steroid injection first and mobilise the area. Surgery is only required if the problem becomes a daily occurrence. WE release the area, bury the nerve from further irritation. Healing is fast normally and recovery low impact and can be done as day case surgery if this is required. Please keep consultingfootpain informed as you input is valuable. David
Thank you so much for your reply! The lump I have is actually on my 5th meditarsal towards the back almost at the midfoot but it’s still on the forefoot,The podiatrist said that it seems to be coming from a tendon in that area.It is not the surgery or the Mri that scares me, it is the findings! The fact that the doctor does not know what the lump is, which is very hard and feels like bone, but it’s not a bone spur and does not show up on X ray,scares me because he put it down as a firm mass, and I’m afraid it’s going to be some kind of sarcoma 🙁 He did run his fingers across my foot and I did get that feeling you’re talking about of like electricity going through it! I don’t know if this helps, but I do walk about 4 miles A-day, but now it’s getting harder, because my foot especially in that area seems to hurt more at the lump. It never bothered me until one day I sat with it pressed up against the floor, and I had horrible pain that I could not deal with for like 3 days. That’s what Made me go to the podiatrist sooner. Sorry for the long post! And thank you so so much for your reply, it is so hard to find anything on these types of things about foot lumps on the Internet.
My reply to Amber –
Amber, first sarcomas are very rare so put this out of your mind. The bone is normally larger at the base of the fifth metatarsal and a tendon inserts into this bone. There is a superficial nerve that runs along the outer part of the foot and in some cases can be irritated. You really need an x-ray first to establish if you have managed a fracture at this site. If you are UK based ring NHS direct and say you have ongoing pain and would like it examined. This is the quickest way of getting an x-ray of you can see a local day hospital set up. Alternatively, speak to you GP’s surgery. I am unsure which doctor you saw but low grade fractures called stress fractures are more common around this location. The surgery can direct you to an x-ray but treatment may be slow. If there is a break it will be small but the tendon will pull against the outer foot whenever your walk. You can search fractures on my site and there is a description – try the search box for ‘fifth metatarsal fracture’. Let me know how it goes. If there is a concern you will then be sent to ‘Fracture clinic’ at you general hospital where the orthopaedic team will provide help. David
Thank you for your fast response! I am actually in the United States 🙁 I wish I was in the UK 🙂 The lump is kind of off to the side but more on the top of the foot, I’ve had several x-rays and Findings were As follows: There is no acute fracture or dislocation, the joint space appears normal,the soft tissues are unremarkable,there is no radiopaque foreign body. That is what The X-ray report reads. I realize that is very hard too know what the lump is without seeing the foot, in the meantime I am awaiting an MRI ! But is it normal for the pediatric to recommend surgery not knowing what the lump is ? He was not even going to do an mri and tell he could see that I was really worried when I came back and then decided to order an MRI. The lump is very hard, and about the size of a dime or maybe a little smaller, And it feels like I can pop it back-and-forth but I think it could just be because it’s on a tendon. I think it just bothers me that he didn’t really act like he knew what it was or give much information, his main response was surgery, Although he did have me try a gel called diclofenic sodium,that did not help shrink it.and then whenever I said I’m worried it’s cancer spreading through my body, he said that’s why we need to get it removed and send it off to a lab. Again thank you for your response!
Reply to Amber –
An MRI is very appropriate as x-rays are sometimes not sensitive enough to cover all options. They are the best place to start. The MRI will take in the tendon and surrounding tissue. Protocols vary between countries, but my experience of the USA is that they are hypersensitive in undertaking tests to rule out any concerns. Soft tissue tumours are much more common than bone tumours and then a swelling is often just a harmless ganglion. Diclofenac sodium may help with pain but it does not have good penetrating power. Diagnosis is essential and surgery is not conducted until a clear picture is confirmed. An ultrasound would have also been helpful but I believe you should await your MRI and try not to worry as foot cancer is rare. I am sure if necessary you will get the right treatment. David
I meant to say is it normal for the podiatrist to recommend surgery?
I have developed a bump on the top of my right foot and it is on the right side of the bone at the base of the big toe. It doesn’t hurt when touched and doesn’t overly bother me at the moment but it does feel my foot is a little larger and the skin feels tight. Any thoughts or advice please?
Hi Paul, thanks for writing in. It sounds like this is part of a bunion, but I cannot be sure without a diagram or picture. Men fair better than the ladies with bumps and footwear. How long has it been present? When were you aware of concerns (timeline may be different), and is it soft or hard? There are a few articles on my site for self-help, so you put in big toe and bunion, hallux valgus and this may offer more guidance. best wishes, David
Hi David my name is Nina I’m 53 years old and I’ve always been a stay-at-home mom except for maybe 10 years of my adult life so not a whole lot to do on my feet however I’ve been diagnosed with osteoarthritis they’ve also told me that I have bone curling going on in my fingers they didn’t check my feet here’s my dilemma I have a bump that is a perfect square almost it does seem to have some fluid pockets underneath it or around it but it’s hard as a rock and it hurts it sets high up off my foot and it doesn’t seem to be going away it started about a year ago I also have severe leg cramps along with this that I never had before either they are debilitating they put me down for an entire 24 hours nearly if I don’t have any more I’m lucky I don’t know if this goes hand in hand but I do know this this thing hurts I can’t wear shoes I’ve tried bypassing the tongue on the shoe by not lacing up over it I tried shoes without laces I’ve tried everything I can and it just kills my foot to wear anything that covers this knot bump or whatever it is I don’t know if it’s bone I don’t know if it’s a cyst I don’t know if it’s just fluid but it doesn’t seem to be just fluid alone because it’s hard as a rock and I cannot move it around I have photos and video and I could send them to you to show you to get your opinion but I don’t know how to post them on here so with that said if you could please email me I would attach photos for you to view as well as to post for future references for anyone else going through this I do have ganglion cysts in my right wrist I’ve had them shot with injections of cortisone and to no avail I’ve had that’s when I found out I had curling bones also osteoarthritis runs in my family but both my daughter and myself have arthritis and she’s had it since she was born she has rheumatoid arthritis she had to have major surgeries she nearly died from this I don’t know if it all goes hand in hand or not I know that she still suffers as a 36 year old woman but she’s alive she was five when this began as far as my bump it began about a year or so ago and it just didn’t stop growing I think it’s pretty much stopped I hope but the pain is overwhelming and before our pocket all the money just to find out there’s nothing no one can do I would love to have your advice thank you
Hi I have 2 lumps on left foot one on right podiatrist says arthritis. They have become more painfull over the years to the point of I now can not walk my dog . My feet are like paddles when I walk they don’t bend. The pain is awful that goes up my legs in bed plus the whole ankle area. Exhausting by the end of the day. I have just paid for a ramp to be put in as stairs are to much. Am doing no pressure on the foot gym work cycling rowing to keep weight down as this will become a problem . I also swim which keeps my head in the right space. If it wernt for this I would be an active fit older person of 69but alas I am here not really knowing what the future holds total disability perhaps. I will be using brufen 800 a couple of times a week
Am waiting on orthotic shoes but as podiatrist said it may help but don’t expect to much . This is an awful condition that really affects normal life on so many levels but we must do what helps
I am sorry to hear about your foot problem. Yes, bumps may represent changes within a joint, but if you suffer from arthritis is in general or localised. I understand your symptoms are foot focused. I would want to take a complete medical and arrange appropriate tests, including blood. 800mg ibuprofen is a very high dose unless you mean 200mg taken weekly to a maximum of 800mg, which I assume. In terms of orthoses, these slip inside the shoes and are not a shoe, they can push any bump on top of the foot into the shoe making matters worse. As I don’t know your country of origin I cannot give much more advice. david
Roughly 20 years ago, I hurt my right foot/ankle extremely bad while playing volleyball. Ever since this injury I have walked with a limp and will shift my body weight to my left side when standing still. I have been to the orthopedic for this particular injury and am in need of an almost reconstructive type surgery, although the doctor doesn’t suggest that surgery for me due to my history of both PE’s and DVT’S as well as him knowing I will not follow the post operative orders and “take it easy” for 6 months. So I have ultimately had to learn how to deal with it. Except roughly 2 weeks ago the top part of my left foot, above the smaller 3 toes I developed a knot that started hurting here and there. But over the last 3 days the knot has gotten bigger, becoming slightly bruised and the pain is now constant. What could this be?
Dear Ashley, at two weeks’ duration, such swellings are either soft tissue, meaning not of bone in origin, or the swelling is from injury or infection. If it is also bruised, that tends to point to localised injury as small blood vessels are involved. ‘Above the small toes’ as a reference is not too clear to judge. If pain is constant and fails to respond to pain medication, or it keeps you awake or had numbness, shooting pains, and footwear is difficult to accommodate, then see either your physician, a podiatrist or foot orthopedist. I am assuming you are USA based? I would want at least an ultrasound diagnostic on this.
Hello I have this edema on top of third metatarsal. I am an avid runner, running about 10K every day.
At the end of October I started noticing pain in the area where shoe laces tie, while running. When I was walking it was slightly sore there but no pain.
I gave it a week of complete rest, started running again, and pain still would come back after first 5 min, and it was still a bit swollen on top.
So I did 2 month of alternative sports, like swimming and cycling. There is no more pain or discomfort when walking, unless I walk really long hours like 3+ hours.
But I still see swelling on top.
Got an X Ray and MRI (self-referred) and it confirmed cuneiform edema but no stress fracture or tendon issues. the final diagnosis is arthrosis.
I am seeing a podiatrist in 2 weeks’ time, but I want to understand what does it mean for my running hobby? And why the swelling still has not gone down more than 2 months after the injury? Is this normal?
Thanks, Richard, for this interesting case. It is useful to have the detail. The third cuneiform is the smallest midfoot bone. Sometimes we use the term bone edema which is a form of internal congestion which can be self-limiting with rest, splinting, and the use of orthoses to stabilise the midfoot. Footwear design attention would be something your podiatrist can advise on. If the joint between the third metatarsal and cuneiform is inflamed a local injection of steroids can reverse the soft tissue inflammation. Some recovery has already taken place. I don’t know your age but this is relevant to recovery. Keep you appointment as it is good to be given advice by a foot specialist. David
Hello David, thank you for your answer. Saw the podiatrist, he explained to be the MRI. The final conclusion is that there is a very minor cartilage damage in the third metatarsal and a small subchondral cyst of 2 mm also in the third metatarsal. He thinks the cyst is causing me discomfort when running.
My questions would be, from your experience do these subchondral cysts go away ? Im a 30 year old male. It has been bothering me for 3 months now.
I will start wearing custom made orthotics but thats about it. Not yet prescribed an injection.
Dear Richard, cysts are a common finding and research to date as it stands, do not suggest these are as critical as they appear. I don’t believe cysts cyst do diminish on their own. If the cyst is large, especially in lesser metatarsals such as the third, it is possible to sustain a fracture if the bone is weakened. Cartilage damage alone is less incriminating when compared to the joint lining. Damage of the lining or inflammation is far more contributory to joint pain.
Please find a link on my site that covers cysts. https://wp.me/p40VT9-eo4 You can also find the article in the search box on the website. David
I have a hard lump on the top right of my left foot closer to the back of my foot (further from the toes) and one in the exact position on my right foot however is on the top left of my foot. (If my feet were pressed side by side they line up together) the bumps are prominent and noticeable however have never caused any sort of discomfort or pain. I noticed them around 2 years ago however have not been an all my life situation and never found a ball park guess online. Don’t necessarily wanna see a dr about it since there is no pain. Any ideas of what could have formed this?
Hi, Tiffany top and back of the foot sound like the talus, a bone that does produce a prominence. If this is what you refer to, it is not uncommon. You don’t have to see a doctor if they are not hurting or troubling you. If you send me a picture to my email address, busypencilcasecfp@gmail.com, I will happily reply and even do an article. Bony projections are the most common question on my site so happy to assist you. David
I have a small hard pea sized lump on the top of my foot. It’s not painful at all and I can’t move it – it’s not squishy- could this be a bone spur?
Does the lump move Pippa? If it is squishy, it is probably not bone. David
I have a lump that is squishy coming out of lateral portal scar from arthroscopy of ankle.
It then goes over the extensor tendons it is excruciating painful like stabbing burning and I get referred pain on top of foot and up side of leg .had EMG done there was spn damage
Inverting foot excaberates symptoms
I thought it was cartilage damage as so painful and lifelimiting
They say nerve damage or entrapment and I’m looking into surgery what are your general thoughts on this .a licidine injection right near the nerve worked for about 3 or 4 hours .
It’s so painful I don’t walk correct and makes my whole leg weak
Can nerve damage be this bad!!!!
Tania, I am sorry to hear about your foot and ankle problem. You are correct in that your portal scar may very well have involved the lateral cutaneous peroneal nerve, which fits your symptoms. I also wonder if you have a ganglionic cyst common to this part of the foot. Lidocaine, an anaesthetic, can only show that pain control can be attained, but it is not treatment. You say you had an EMG done which is electromyography which would not really be valid as an MR imaging to show up the problem. Again inversion of the ankle will set off the nerve symptoms. Yes nerve damage can be this painful and I would consider nerve entrapment. Local anaesthetic with steroid is the first line of management to soften the scar tissue. Local nerve exploration and coverage to release the nerve scar may be necessary. There are other techniques but you should ask your surgeon what their management is intended as you are right this needs resolving. David
Thank you for your article I found it very interesting m I too have a bony protuberance on my right foot just on instep , doesn’t seem to grown but late at night aches, and when foot is on the floor there is no sign of it, but flexing my foot downwards it is visible , approx ten to twelve years ago I fell down stairs and although it wasn’t broken I was in a plaster cast for six weeks ….
Thanks for sharing Pam. Sometimes injuries cause flare up of these prominences. Massage and anti-inflammatories gels can assist take away the ache as well as a warm foot bath. Careful selection of shoes to avoid rubbing and pressure is important as a self help strategy. Joint synovitis can make matters worse and this can be quietened down around and inside the joint but requires professional intervention.
Thank you for posting this article. I have a full time office job sitting at a desk. But about four months ago I started also working a part time delivery job. I became addicted because I noticed weight loss and more activity. Almost like getting paid to work out. I really enjoy it. However my feet have been taking turns hurting. There is a lump that forms on top of my feet. It hurts to the point of me limping. It’s very tender. I’m only 44.
Hi Lisa, many health problems accelerate when we change our mode of life. Sedentary occupations have their benefits but also their downsides. Activity from our thirties + reminds us we may not be old in the sense of looking old, but we do find those signs of aging creeping in. A bump in itself is inconvenient as it makes selecting footwear difficult. Too tight, not enough space, too high a pitch to the heel and it all becomes uncomfortable. That said you may well be wearing perfect footwear for this delivery role. Jumping in and out of a vehicle places mid foot strain and that is almost certainly happening. The mid foot is poorly appreciated by non foot health professionals and it is within this mid part that pockets of inflammation may be exacerbated by the constant forces of your job. Do use an over the counter gel or cream that helps inflammation and see if this bring relief. Some benefit from glucosamine – the chemical molecules that make cartilage work well. This are taken daily – indeed I use glucosamine myself. Try an inlay that has a small raise to stabilise the mid foot joints. This come online or from local pharmacies. Massage your feet after a warm bath – or use a foot spa bath. If none of these ideas improve matters, check out a qualified podiatrist DPM in the USA or Canada, to ensure that there is nothing untoward like a hairline fracture. Bumps can be removed but often it is soft tissue around the area, including a fluid sac called a bursa. At 44 you need to do the right thing as keeping active is better than being stationary. Good luck and email me to tell me how it goes – busypencilcasecfp@gmail.com David