Author: Mr Oliver Eaton BSc (Hons), PG.Cert – Orthopaedic Specialist
Reviewed by: Mr William Sharples BSc (Hons) – Pain Management Expert
Last Updated: September 2025
In this article, you will learn everything you need about arthritis at the top of the foot and the most effective ways to treat it, including an advanced treatment called prolotherapy.
Top of Foot Arthritis: Causes, Relief, Prolotherapy & Expert Advice
Introduction
Top of foot arthritis is a common but often overlooked cause of chronic foot pain and stiffness. It can affect your ability to walk, exercise, and enjoy daily life. This expert-reviewed guide explains the causes, symptoms, and best treatments for top of foot arthritis, including advanced options like Prolotherapy. We’ll also cover prevention, real patient stories, and frequently asked questions to help you make informed decisions about your foot health.
What is Top of Foot Arthritis?
Top of foot arthritis refers to inflammation and degeneration of the joints on the dorsum (top) of the foot, most commonly the tarsometatarsal (TMT) joints. The most frequent type is osteoarthritis, but rheumatoid arthritis, gout, and post-traumatic arthritis can also affect these joints. Over time, cartilage wears away, leading to pain, swelling, and sometimes bony lumps (NHS, 2023).
Arthritis in this area can make it difficult to wear shoes, walk long distances, or participate in sports. Early diagnosis and treatment are key to maintaining mobility and quality of life.
Anatomy of the Foot
The top of the foot contains several small joints, including the tarsometatarsal (TMT) joints, which connect the long metatarsal bones to the tarsal bones. These joints are crucial for foot stability and movement. Cartilage covers the ends of the bones, allowing smooth motion. When this cartilage breaks down, bones rub together, causing pain and inflammation.
Ligaments, tendons, and muscles also support the foot. Damage or degeneration in any of these structures can contribute to arthritis symptoms.
Causes and Risk Factors
- Age: Risk increases with age, especially over 40.
- Previous injury: Sprains, fractures, or midfoot injuries can damage the joints and accelerate cartilage wear.
- Genetics: Family history of arthritis or foot problems increases risk.
- Repetitive stress: Running, sports, or jobs that put pressure on the top of the foot.
- Foot structure: Flat feet, high arches, or abnormal gait can increase joint stress.
- Other arthritis types: Rheumatoid arthritis, gout, or psoriatic arthritis can affect the top of the foot.
- Obesity: Excess weight puts more pressure on foot joints, increasing risk of arthritis and pain.
- Occupational factors: Jobs that require prolonged standing, walking, or heavy lifting.
Citations: Versus Arthritis, 2023; NHS, 2023
Symptoms and When to Seek Help
- Pain and stiffness on the top of the foot, especially when walking, standing, or wearing tight shoes
- Swelling or tenderness over the affected joints
- Difficulty bending the foot or toes
- Grinding, clicking, or popping sensations
- Development of bony lumps (osteophytes) or visible swelling
- Redness or warmth (inflammatory arthritis or infection)
- Reduced range of motion or difficulty pushing off when walking
- Occasional numbness or tingling if nerves are compressed
Seek medical attention if:
- Pain is severe or sudden
- You notice significant swelling, redness, or warmth
- You cannot walk or bear weight
- There is significant deformity or locking of the foot
- You develop fever or signs of infection
Diagnosis
A healthcare professional will diagnose top of foot arthritis by:
- Taking a detailed medical history and asking about your symptoms, activity levels, and previous injuries
- Performing a physical examination, checking for tenderness, swelling, and range of motion
- Ordering imaging tests (X-ray, MRI, or ultrasound) to assess joint damage, bone spurs, or other causes
- Blood tests if inflammatory arthritis or gout is suspected
- Diagnostic injections (local anesthetic) to confirm the source of pain
Early diagnosis is key to effective treatment and preventing further joint damage. Imaging can also help rule out other causes of foot pain, such as stress fractures or tendon injuries.
Citation: NHS, 2023
Treatment Options
Treatment for top of foot arthritis depends on the underlying cause, severity, and your overall health. Most people benefit from a combination of self-care, medical treatments, and lifestyle changes. Early intervention can help slow progression and reduce pain.
Self-Care and Lifestyle
- Rest and activity modification: Avoid activities that worsen pain, such as running or high-impact sports. Take breaks during long periods of standing or walking.
- Ice therapy: Apply ice packs for 15–20 minutes after activity to reduce inflammation and swelling.
- Supportive footwear: Wear shoes with a wide toe box, stiff sole, or rocker bottom to reduce pressure on the joints. Avoid high heels and tight shoes.
- Gentle stretching and strengthening: Focus on the foot, ankle, and calf muscles to maintain flexibility and support.
- Weight management: Maintaining a healthy weight reduces stress on the foot joints and can significantly decrease pain.
- Use of orthotics: Custom insoles or arch supports can help distribute pressure more evenly across the foot.
- Warm soaks: Soaking your feet in warm water can help relax muscles and ease stiffness.
Medical Treatments
- Pain relief: Over-the-counter medications such as paracetamol or ibuprofen can help manage pain and inflammation.
- Topical treatments: Anti-inflammatory creams or gels applied directly to the foot may provide targeted relief.
- Physical therapy: A physiotherapist can design a program to improve mobility, strength, and balance, and teach you how to protect your joints.
- Injections: Corticosteroid or hyaluronic acid injections may be considered for persistent pain and inflammation.
- Treatment of underlying conditions: Managing gout, rheumatoid arthritis, or other systemic diseases is crucial for long-term control.
- Assistive devices: Walking sticks, canes, or shoe modifications may be recommended for severe cases.
- Surgical options: In advanced cases, surgery such as joint fusion (arthrodesis) or joint replacement may be considered.
Citations: Versus Arthritis, 2023; NHS, 2023
Prolotherapy
In recent years, Prolotherapy has built its reputation within the medical community for its clinically proven ability to treat top of foot arthritis. Published research has proven its pain-relieving, anti-inflammatory and regenerative benefits.
Prolotherapy involves injecting a natural regenerative solution with tiny needles. This has been shown to stimulate the production of collagen cells, the small cells needed to help with top of foot arthritis.
As prolotherapy is helping to treat the root cause of top of foot arthritis, it is deemed to be a permanent fix, preventing the symptoms from returning.
Disclaimer: The information provided in this section is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Prolotherapy may not be suitable for everyone, and outcomes can vary. Always seek the guidance of a qualified healthcare professional regarding your specific medical condition or treatment options. Never disregard professional medical advice or delay seeking it because of information you have read here.
Rehabilitation and Recovery
A structured rehabilitation program is essential for long-term relief and improved mobility. This may include:
- Gradual return to activity under professional supervision
- Strengthening exercises for the foot, ankle, and calf
- Balance and proprioception training to prevent falls and further injury
- Education on joint protection and pacing strategies
- Regular follow-up to monitor progress and adjust the plan
Recovery time varies depending on the cause and severity of your top of foot arthritis. Most people see improvement within weeks to months with consistent care. Severe or advanced cases may require longer rehabilitation and ongoing management.
Citation: PhysioPedia, 2023
Prevention Tips
- Maintain a healthy weight to reduce stress on your feet
- Wear supportive, well-fitting footwear with adequate cushioning
- Warm up before exercise and cool down afterward
- Strengthen and stretch the muscles around your foot and ankle regularly
- Avoid repetitive high-impact activities or vary your exercise routine
- Address biomechanical issues with orthotics if needed
- Seek prompt treatment for foot injuries to prevent long-term complications
- Monitor for early signs of arthritis and seek early intervention
Regular check-ups with a physiotherapist or podiatrist can help identify and address risk factors before they lead to chronic pain.
Case Studies
Case Study 1: Mary, a 62-year-old teacher, developed top of foot arthritis after years of running. She received a combination of physiotherapy, footwear advice, and prolotherapy. Within three months, her pain reduced and she returned to walking daily.
Case Study 2: Tom, a 48-year-old office worker, experienced chronic pain on the top of his foot due to osteoarthritis. After prolotherapy and a tailored exercise program, he regained mobility and now enjoys hiking again.
Case Study 3: Linda, a 55-year-old chef, suffered from rheumatoid arthritis affecting the top of her foot. She received disease-modifying medication, physical therapy, and prolotherapy, and is now able to stand comfortably during long shifts.
Case Study 4: James, a 35-year-old football coach, developed post-traumatic arthritis after a midfoot fracture. He benefited from custom orthotics, a structured rehab program, and prolotherapy, returning to coaching and light jogging within six months.
Case Study 5: Emily, a 29-year-old dancer, experienced early signs of top of foot arthritis. Early intervention with physiotherapy, footwear changes, and prolotherapy allowed her to continue dancing without pain.
FAQs
What causes top of foot arthritis?
Common causes include age-related wear and tear, previous injuries, repetitive stress, genetics, and inflammatory conditions like gout or rheumatoid arthritis.
Can I exercise with top of foot arthritis?
Yes, but focus on low-impact activities and gentle stretching. Avoid activities that worsen pain and consult a physiotherapist for guidance.
Is prolotherapy safe for top of foot arthritis?
Prolotherapy is considered safe when performed by a qualified practitioner. It is minimally invasive and has a low risk of complications.
When should I see a doctor?
If you have severe pain, swelling, redness, or cannot walk, or if symptoms persist despite self-care, consult a healthcare professional.
How long does it take to see results from treatment?
Most people notice improvement within a few weeks, but full recovery may take several months depending on the cause and treatment plan.
Can top of foot arthritis be cured?
There is no cure for arthritis, but symptoms can be managed and progression slowed with early intervention, lifestyle changes, and appropriate treatment.
What shoes are best for top of foot arthritis?
Choose shoes with a wide toe box, good arch support, cushioning, and a stiff or rocker-bottom sole. Avoid high heels and tight shoes.
Can diet help with top of foot arthritis?
A healthy, anti-inflammatory diet rich in fruits, vegetables, whole grains, and omega-3 fatty acids may help reduce inflammation and support joint health.
Is surgery ever needed for top of foot arthritis?
Surgery is considered for severe cases that do not respond to conservative management. Options include joint fusion or, rarely, joint replacement.
Conclusion
Top of foot arthritis can be painful and limiting, but effective solutions are available. By understanding the causes, seeking early diagnosis, and following a comprehensive treatment plan—including innovative options like prolotherapy—you can achieve lasting relief and return to your active lifestyle. Don’t let foot pain hold you back—take the first step toward recovery today.
Contact ProHealth Clinic Today for Your FREE 15-Minute Discovery Call
Don’t let top of foot arthritis control your life any longer. Join the thousands of patients who have found lasting relief through prolotherapy at ProHealth Clinic.
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Author Bio
Having performed over 10,000 procedures, Mr Oliver Eaton is one of the UK’s leading practitioners in the field of treating top of foot arthritis, with patients travelling to see him from across the UK, Europe, and the Middle East.
With over 12 years of clinical experience, Oliver is dedicated to helping patients understand their symptoms associated with top of foot arthritis and providing effective treatment options to alleviate them.
He first trained in Prolozone Therapy and Prolotherapy in America with the American Academy of Ozonotherapy and continued on to complete further training with the Royal Society of Medicine, Charing Cross Hospital in London, Keele University’s Anatomy & Surgical Training Centre, and the medical department of Heidelberg University in Germany.
Mr Eaton developed his treatment and examination approach through the process of treating his own chronic symptoms and is committed to making sure his patients experience the same life-changing effects his treatments had on him.
Over the years he has had the privilege of treating many elite-level athletes, including both Olympic and Commonwealth medallists.
Mr Eaton’s expertise has been featured in many national news and media publications, including The Telegraph, The Daily Mail, The Daily Express, Women’s Health Magazine, and The Scotsman.
LinkedIn profile: https://www.linkedin.com/in/oliver-eaton-4338225b/
References
- NHS. (2023). Osteoarthritis
- Versus Arthritis. (2023). Osteoarthritis
- PhysioPedia. (2023). Foot Osteoarthritis
- Arthritis Foundation. (2023). Osteoarthritis
Disclaimer: This article is for informational purposes only and does not substitute for professional medical advice. Always consult your healthcare provider before making treatment decisions.