PATIENTS often come to my office with random, unexplained pain on the top surface of their foot. The pain may be uncomfortable when walking, running, standing still, or even when lying down. The cause will usually determine how severe the discomfort is.

There are many different conditions that can cause pain on the top of the foot. Most are due to overuse of the limb. I find that people often experience this problem when they have been on holiday and have done an uncharacteristically large amount of walking.

Any activities like running, jumping or kicking may lead to pain in this area. Examples of some of these conditions are:

1. Extensor tendonitis: This is when the tendons on top of the foot are pulled upwards and become inflamed. This can be caused by poor footwear for overuse of the foot.

2. A stress fracture, due to trauma in one of the long bones in the foot (metatarsal) will cause pain, swelling and reduce mobility.

3. Sinus tarsi syndrome is quite rare and is where there is inflammation in a channel found between the heel bone and ankle bone.

4. Bone spurs don’t only occur on the heel but can be found on other bones.

5. Peripheral neuropathy is damage to the nerves in the feet. This can cause burning, pins and needles, numbness, and stabbing pains.

6. Common peroneal nerve dysfunction can lead to pain and weakness on the top of the foot.

7. Gout.

8. Arthritis.

9. Obesity.

Diagnosis of dorsal foot pain is made by clinical examination, X-ray and possible magnetic resonance imaging scan.

As always, treatment depends on the cause. If there is a fracture, an air-cast boot is recommended. Rest is always the first step to recovery. Immobilising the area or reducing your movement will give the injury time to heal. Icing the area four times a day for 10 minutes will reduce the pain and footwear should be supportive but not too tight.

Most of these conditions are due to inflammation and I like to recommend turmeric tea as a natural anti- inflammatory. Your general practitioner may prescribe non-steroidal anti-inflammatory medication. Physiotherapy can also be a great help.

Our feet are complicated structures that carry our entire body weight daily, so it is no surprise that they protest on occasion. Make sure you treat and dress them with the respect that they deserve.

Angela Davis BSc (Hons) DPodM MChS is a podiatrist with offices in Montego Bay (293- 7119), Mandeville (962-2100), Ocho Rios (974-6339), Kingston (978-8392), and Savanna-la-Mar (955-3154). She is a member of the Health and Care Professions Council in the United Kingdom.