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Pain in the instep of the foot: causes and treatment

by Alivia Nyhan
Published: Last Updated on

Anatomically, the instep is the dorsal area or the top of the foot, it is made up of 28 bones and 9 extensor tendons that come from the leg. This particular area can usually be affected due to the impact it receives when walking or performing different activities, especially since it is an exposed area and it is estimated that it must support an equivalent to 2 times our body weight.

The most common causes related to pain in the instep are tendinitis and pain due to bone deformity of the pes cavus and flat feet. If you want to know more about pain in the instep of the foot: causes and treatment , we invite you to continue reading this article by FastlyHeal .

Foot anatomy

The foot has a special structure that allows the human being to stand and move, and its structure allows it to support almost twice the body weight. The feet:

  1. They act as a buffer.
  2. They allow you to maintain balance.
  3. They provide us with all the necessary characteristics to walk, run, jump.

Anatomically, the instep is located on the top of the foot. It is made up of 28 bones and corresponds particularly to bones:

  • Scaphoids.
  • First wedge.
  • Second wedge.
  • Third wedge.
  • Cuboides.
  • Metatarsianos

On the other hand, it has 9 extensor tendons that allow it to pull the toes upwards and that come from the leg. Two tendons for each finger from the first to the fourth finger and one tendon for the fifth toe.

Causes of pain in the instep of the foot

Once the complex structure of the instep of the foot is known, many causes related to pain that may occur in this area must be taken into consideration. Among the most common causes of pain in the instep of the feet, we find:

Tendonitis in the foot

A common condition in which pain in the instep of the foot can occur is known as tendinitis , which is the inflammation of some of the extensor tendons that make up this complex structure of the foot.

Tendinitis, generally, is caused by overloading of a muscle near the tendon due to the use of too narrow footwear.

In addition to the pain resulting from the inflammatory process of the tendon, tendinitis can manifest itself with: swelling in the instep, discomfort when putting on shoes and a symptom that allows the doctor to diagnose this condition, which is known as tendon crepitus, a kind of clicking noise. when extending or flexing the toes.


Loss of normal continuity of a bone can be caused by a blow to the foot or an unknown cause, known as a stress fracture. Generally, the fracture in this area occurs in one of the metatarsals and this type of fracture is related to:

  1. Foot overload.
  2. Muscular weakness.
  3. Increased level of daily activity.
  4. Rough exercise.
  5. Sedentary.
  6. After being idle.

Pie cable

This occurs when there is an abnormal elevation of the instep , in addition, the toes can be flexed inward. With this condition, there is a prominent instep with well marked muscle and tendon retraction, in this way, the wedges are stressed.

A large percentage of people who suffer from this cavus foot syndrome are related to a basic neurological disease.

The initial form with which this condition manifests is with pain in the instep of the foot, likewise pain appears in the heel, forefoot and under the toes, shortening of the length of the foot, difficulty in wearing footwear, pain when standing upright. standing or walking.


In this case, the instep is somewhat sunken, the wedges are compacted, approaching more than normal and causing a collapse in this area.

The pain that can occur is after performing a specific activity. Likewise, the person with flat feet may manifest:

  • Clumsiness when walking
  • Constant falls.
  • Sensitivity.
  • Frequent cramps

Sinus tarsi syndrome

The sinus tarsi is a kind of canal that is located between the heel and ankle bone, through it ligaments, blood vessels and nerves run. This syndrome is caused by forced trauma due to an inward twisting of the foot or as a result of an ankle sprain, it can also be related to repetitive exercises such as, for example, practicing baseball or ballet.

Sinus tarsi syndrome is characterized by pain in the upper part of the foot due to the inflammatory and irritating process in this area. It is probable that when waking up the ankle is stiff and with limitation to the movements that it gradually gives way.

Hammer finger

In this case, it is a bony deformity of one or more toes that bend downward. Its cause is related to the use of footwear that is smaller than the corresponding size, the use of shoes with a sharp point or due to some predisposing alteration at the muscular level.

The pain from suffering from hammer toe is usually intense and tends to worsen after the appearance of calluses that may form due to this typical position of the fingers.


Gout is a rheumatic disease characterized by the formation of uric acid crystals in the tissues and joints. This triggers a kind of inflammatory response in the farthest parts of the body, that is, the extremities. The foot is usually a common area of ​​involvement, especially the hallux toe or big toe.

Although this condition affects the joints of the fingers, if the inflammatory process is of great magnitude, the pain extends to the instep of the foot. The pain is sharp and increases especially at night, that is, when they are usually at rest.

Usually, gout appears due to suffering from diabetes mellitus, obesity, genetic predisposition or due to a diet rich in purines, that is, in meats.

Nerve entrapment pain

This is due to compression of some nerve branch by some anatomical structure of the foot, be it bone or muscle. The causes are varied, generally due to the use of tight footwear or trauma to the foot.

Characteristically, instep pain, stinging, and numbness appear.

Ganglion cyst pain

In the instep area, a kind of bulging of liquid content may appear , usually caused by an injury that conditions the outflow of this joint fluid. Consequently, it accumulates in the soft tissues, forming what is known as an instep ganglion cyst.

The bump is usually painful and variable in size, from the size of a pea to the size of a golf ball.

Foot fungus

Occasionally, the foot can be affected by a fungal infection , which can occur on any part of the skin but, especially, in the moist regions such as between the toes.

This fungal condition can cause pain between the toes to spread to the instep, both in the lateral areas and on the upper face, as well as peeling of the skin and even infection of it due to intense scratching.

Tarsal coalition pain

It is the junction between the tarsal bones. It is a congenital problem and can cause pain, stiffness, and instability in the foot.

Pain in the instep of the foot: medical treatment

Given the different causes, the doctor must make the diagnosis to individualize the treatment of pain in the instep of the foot , which may include:

  1. Treatment with non-steroidal anti-inflammatory drugs such as diclofenac or ibuprofen to relieve pain and swollen instep, these can be used topically or orally.
  2. Rest until the pain disappears, it is recommended to place your foot up to improve circulation.
  3. Avoid pressure on the instep, wearing custom and comfortable shoes.
  4. Perform physical therapy to strengthen the tendons of the foot.
  5. Sometimes the use of a support bandage is necessary.
  6. Use crutches to avoid weight on the injured foot.
  7. Use orthopedic pads in shoes to have better support and avoid foot sprains.
  8. Ultrasound or electrotherapy may be indicated to reduce inflammation.
  9. Your doctor may order muscle-training exercises, either strengthening or stretching.
  10. Swimming may be indicated to improve joint movement.
  11. Surgical intervention is indicated when necessary, such as ganglion cyst and hammer toe.

How to relieve pain in the instep of the foot

To relieve pain in the instep of the foot you can easily use the following measures until the doctor evaluates you:

  • RICE method is the most used: rest, ice, compression and elevation of the affected limb. Especially ice takes care of vasoconstriction and therefore reduces pain and inflammation.
  • You can use lukewarm baths with a tablespoon of salt alternated with cold water, you should first place your feet in the warm water for 3 minutes and then in the cold water. This method allows you to relax your feet and reduce inflammation.
  • Perform bottle stretching massages from heel to toe for 10 minutes and repeat every hour until pain is gone.
  • Massage with moisturizing cream or oils such as argan, rose or almond.
  • Do not wear shoes, go barefoot at home, on a flat surface. This will strengthen and tone your feet.
  • Chamomile tea has anti-inflammatory properties, you can take it to soothe the pain in the instep or massage the tea on the top of the foot.
  • You can also use massages or baths with sage, thyme or rosemary for pain.

This article is merely informative, at FastlyHeal .com we do not have the power to prescribe medical treatments or make any type of diagnosis. We invite you to see a doctor in the case of presenting any type of condition or discomfort.

If you want to read more articles similar to Pain in the instep of the foot: causes and treatment , we recommend that you enter our category of Bones, Joints and Muscles .

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