Bumps on Top of the Feet: Causes and Treatment

There are many causes of bumps and lumps on top of the foot, but two of the most common are:

  1. A bone spur on top of the foot called an exostosis (tend to be firm and non-movable)
  2. A soft fluid filled sack called a ganglion cyst

This page focuses primarily on the first cause: bone spurs. We’ll discuss the cause in more depth and guide you through the best treatment options.

Click here for more information on soft lumps on top of the foot caused by ganglion cysts.

Video: Bump on Top of the Foot – Causes and Treatment

Bony bumps and Bone Spurs on the Top of the foot

The most common cause of a bone spur on top of the foot is a condition called metatarso-cuneiform exostosis. This hard bump occurs on top of the foot usually at the junction of two bones – your first metatarsal bone and your medial cuneiform bone.

This type of bone spur occurs over time due to pressure between these two bones.

There is a law of physiology called “Wolfe’s Law”. It says that when pressure is applied to bone over time, bone will grow. These top of foot bone spurs occur when the foot flattens excessively and these bones are pressed together as seen in figure one and as shown in the video. Over time this pressure between the bones leads to formation of the bone spur.

Treatment of Top of Foot Bone Spurs

We recommend that surgery should be considered only as a VERY last resort. In fact we can almost always treat these conditions without surgery. If you have a bump on the top of your foot that you need treated, contact us for an appointment in our Seattle clinic.

We have several primary treatment goals to eliminate pain from top of foot bone spurs:

  • Change the shoe lacing technique so that the laces skip over the area of the bump. You can also use elastic shoe laces so the shoe will give a bit over the bump.
  • Use orthotics to stop the two bones from jamming together. Good arch supports not only stop the foot from collapsing, but reduce pain and help prevent the bump from getting bigger. The most effective  way to do this is to use specialized custom orthotics called “total contact orthotics”.
    • Quality over-the-counter arch supports can help too, especially for smaller bumps. These OTC supports should

      Adjustable Arch Orthotics

      conform very close to the arch of the foot in order to stop the compression between the bones. Our favorite OTC arch support for this condition are FootChair Orthotics with Adjustable Arch Height.

    • For women’s dress shoes including heels and flats we recommend the FootChair Slim Orthotic with adjustable arch height. It has the same excellent adjustable arch as the full size FootChair but is much smaller and flexes to fit in different heel heights.  Can be used in up to a 4″ heel.
    • For soccer cleats and other small dress shoes, we also recommend the FootChair Slim Orthotic.
  • Steroid injection: Sometimes there is an inflamed bursa on top of the bone spur that can be treated with a cortisone injection. If the bump is only from bone then the injection will not help.
  • If all conservative treatment fails then surgery is an option to remove the bone spur. The surgery is usually very successful but in almost all cases we can treat this problem without resorting to surgery. If your doctor has recommended surgery, contact us first for a second opinion.

If you have developed a bump on either foot, you may have developed a bone spur. Especially if the bump has become painful, please make an appointment today in our Seattle foot and ankle clinic, where we will make every effort to avoid surgery for foot bumps and provide you with effective treatment and relief.

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