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 orpump 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:

  1. Is it painful?
  2. Is it soft or hard?
  3. Is it a different colour than other foot skin?
  4. 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.’


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!


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.


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
  • 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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