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Dealing with a bone spur on the top of your foot can be a painful experience. The mere act of slipping on shoes that place pressure on this area can be excruciating, impeding even the most basic of daily routines.
In this article, we’ll delve into the root causes, symptoms, and treatment options for bone spurs that occur on the top of the foot.
Where Do Bone Spurs on the Top of the Foot Occur?
Bone spurs in the top of the foot occur in the midfoot region, where the small bones that connect the rearfoot to the forefoot are located.
These bones are held together by ligaments and have tendons and nerves running over them. When a bone spur grows on the top of the foot, it can cause pain in these areas, including the tendons and nerves.
Bone spurs typically occur at the metatarsal cuneiform joints. This is a condition called “metatarso-cuneiform exostosis.”
Here is a picture of a bone spur on the top of the foot.
What Causes Bone Spurs on the Top of the Feet?
Unlike heel spurs, bone spurs on the top of the foot are caused by degenerative changes secondary to osteoarthritis.
Due to a lack of cartilage along the joint surfaces, the body builds up excess bone to try to repair the area, resulting in spurring.
It will appear as if you have an extra bone growth or “foot lump” on the top of the foot.
Bone spurs can also be caused by post-traumatic arthritis.
Say for instance you played soccer when you were younger and fractured your midfoot. Post-traumatic arthritis could occur and create a bone bump in the joint.
Bone spurs can also be caused by auto-immune diseases such as rheumatoid arthritis and inflammatory arthritis such as Charcot arthropathy.
What Does a Spur Feel Like on the Top of the Foot?
Bone spurs are mostly characterized by discomfort, and can cause a range of symptoms including:
- Dull, achy pain on the top of the foot
- Pain during walking and rest
- Pain while walking on uneven surfaces or walking up the stairs
- Sharp tingling/burning pain on the top of the foot that extend into the toes
- Pain when wearing shoes that press on the top of the foot
- Stiffness in the joints of the midfoot
How Is a Foot Lump Diagnosed?
If you are experiencing a painful lump or bone spur on the top of your foot, it’s important to make an appointment with a Podiatirst for an accurate diagnosis.
During your visit, your doctor will take a detailed history of your symptoms and perform a physical examination of your foot.
To determine the exact location of the pain, your doctor will use their hands to gently press on different areas of your foot. They may also order x-rays to examine the midfoot joints for signs of narrowing or spurring.
In some cases, an MRI may be necessary to confirm the presence of arthritis or rule out other conditions such as fractures or tendon injuries.
Bone spurs can sometimes irritate the nerves on the top of your foot, causing burning or tingling sensations. Your doctor may perform a “Tinel’s test” by tapping on individual nerves to see if you experience any pain or discomfort that radiates into your toe. This can help identify the presence of nerve compression or damage.
How Do You Treat a Bone Spur on the Top of the Foot?
Non-surgical Treatment for Foot Bone Spurs on the Top of the Foot
Pain associated with bone spurs can be treated with RICE therapy and NSAIDs. This can help reduce pain and inflammation at the midfoot.
Voltaren 1% gel is a fairly inexpensive topical NSAID gel that you can rub onto your foot. It helps reduce dull, achy pain associated with arthritis. You can buy it on Amazon.
If you are experiencing mostly nerve pain on the top of your foot, you can try obtaining Lidocaine 4% patches and applying them on the top of your feet. You can wear them on your feet for up to 12 hours. They will help make the top of your foot numb.
Orthotics can be beneficial in reducing pain associated with a bone spur. Orthotics can help redistribute pressure away from the midfoot, and also helps reduce shock at the midfoot joints.
Custom orthotics are ideal because they would be custom-made for your feet. You can visit your local foot doctor to have your feet molded to obtain custom inserts. Custom inserts last much longer than over-the-counter inserts.
Custom inserts can last 5-10 years, versus over the counter inserts that usually last 6 months to 1 year.
In many cases, custom orthotics may be covered by your insurance. It’s best to call your insurance company to check to see if they are covered.
Custom orthotic prices can range from $400-$800.
A carbon fiber plate can also be beneficial in reducing pressure and relieving shock in the midfoot.
It is essentially a stiff plate that you place into your shoes (underneath your shoe liner).
It makes the bottom of the shoe stiff and prevents excess motion in the painful midfoot joints. You can buy it here on Amazon.
Corticosteroid injections can be immensely beneficial in reducing pain associated with bone spurs on the top of the foot.
Your foot doctor will inject a steroid into the midfoot and this can help reduce pain and inflammation.
Generally, injections for arthritis will help relieve midfoot pain for up to 3-6 months.
Surgery for Bone Spurs That Are Causing Pain
When conservative treatment fails, surgical treatment may be needed to reduce pain associated with a bone spur on the top of the foot.
If you are experiencing pain from the bone spur, and have minimal arthritis in the joints, your doctor may recommend simply shaving off the painful bone spurs. This can be done under anesthesia in the operating room.
Afterwards, you can walk partial weight-bearing in a walking boot for up to 4-6 weeks after surgery before transitioning into an athletic shoe.
However, in some cases, extensive arthritis or joint injury of the midfoot joints may be present. If this is the case, your doctor will recommend removing the bone spurs and fusing the midfoot joints.
Fusing the midfoot joints helps prevent motion in the joints, thus reducing pain. This procedure is more involved and would be a more lengthy recovery.
Your doctor will perform the surgery under anesthesia in the operating room. He/she will use plates/screws/stapes to fuse the midfoot joints.
You will need to remain off of your feet for 6-8 weeks minimum in a cast boot/splint to allow for the bones to properly fuse.
This would be followed by gradual weight bearing in a cast boot for 4 weeks before transitioning into an athletic shoe.
Surgery for bone spurs can be done by a Podiatrist or an Orthopedic Surgeon.
How to Prevent Spurring in the Feet?
One way to prevent bone spurs is to wear well-fitting shoes that provide adequate support and cushioning. It would be wise to wear a larger and softer shoe that does not press on the foot.
Shoes that are too tight or too loose can cause friction and pressure on the feet, leading to the development of bone spurs over time.
Another way to prevent bone spurs is to engage in low-impact exercise that supports foot health, such as walking, cycling, or swimming.
Additionally, maintaining a healthy weight can reduce the pressure on the feet and lower the risk of developing bone spurs.
Stretching the feet and legs regularly can also help prevent bone spurs by promoting flexibility and reducing muscle tension. This can also help prevent muscle injury and tendon injury.
Differentiating Bone Spurs on the Top of the Foot From a Toe Spur, Heel Spur, and Ankle Spur
Bone spurs on the top of the foot can be easily confused with other conditions, such as a toe spur, heel spur, or ankle spur.
A toe spur is a bony outgrowth that develops on the joint of a toe, typically the big toe, and can cause pain and discomfort when walking.
Plantar fasciitis is another common foot condition that can cause pain on the bottom of the foot near the heel, often mistaken for a heel spur.
Obesity plays a key role in the development of both plantar fasciitis and heel spurs, as the excess weight puts added pressure on the feet.
In contrast, bone spurs on the top of the foot are typically caused by degenerative changes secondary to osteoarthritis.
Complications
While surgery to remove bone spurs on the top of the foot can be effective in relieving pain and improving mobility, it is not without risks.
There are several potential complications that can arise from midfoot surgery, including inadequate wound healing, nerve damage, nonunion, irritation of hardware, and infection.
Inadequate wound healing can occur if the surgical incision does not heal properly. This can lead to infection and delayed recovery time.
Nerve damage from surgery can cause loss of sensation, pain, or weakness in the foot.
Nonunion refers to the failure of the bones to properly fuse after surgery, which can result in continued pain and require additional treatment.
Hardware irritation can occur if any metal screws or plates used to hold bones in place during the surgery cause irritation or discomfort. In some cases, hardware may need to be removed.
Finally, infection is a possible complication of any surgical procedure, and can occur if bacteria enters the wound during or after the surgery.
It’s important to discuss these potential complications with your foot doctor before deciding to undergo surgery.
Make sure to follow all post-operative care instructions carefully to reduce the risk of complications.
Conclusion
In conclusion, if you’re experiencing discomfort from a bone spur or bump on the top of your foot, it’s important to seek treatment. A Podiatry group can help center your care and provide expert advice on how to relieve midfoot pain. There are many things you can do to manage symptoms, such as wearing supportive shoes, engaging in low-impact exercise, and maintaining a healthy weight.
However, if conservative therapy fails, surgery may be necessary to address the underlying issue. Don’t ignore foot pain or discomfort – schedule a visit with your foot doctor today to discuss your options and get the relief you need.
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References
- Kurup H, Vasukutty N. Midfoot arthritis- current concepts review. J Clin Orthop Trauma. 2020 May-Jun;11(3):399-405. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7211829/
- Thomas MJ, Peat G, Rathod T, Marshall M, Moore A, Menz HB, Roddy E. The epidemiology of symptomatic midfoot osteoarthritis in community-dwelling older adults: cross-sectional findings from the Clinical Assessment Study of the Foot. Arthritis Res Ther. 2015 Jul 13;17(1):178.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4499901/
- Harish Kurup, Nijil Vasukutty, Midfoot arthritis- current concepts review, Journal of Clinical Orthopaedics and Trauma, Volume 11, Issue 3, 2020, Pages 399-405. https://www.sciencedirect.com/science/article/abs/pii/S0976566220300837
- Rao S, Baumhauer JF, Becica L, Nawoczenski DA. Shoe inserts alter plantar loading and function in patients with midfoot arthritis. J Orthop Sports Phys Ther. 2009 Jul;39(7):522-31.https://pubmed.ncbi.nlm.nih.gov/19574663/
- Bawa V, Fallat LM, Kish JP. Surgical Outcomes for Resection of the Dorsal Exostosis of the Metatarsocuneiform Joints. J Foot Ankle Surg. 2016 May-Jun;55(3):496-9.
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