Bump on Top of the Foot
- David Tollafield
- Apr 25
- 7 min read
Updated: May 2
If you’ve noticed a lump on the top of your foot, you probably wonder what to do and need to know what it is.
Many suffer from a foot bump on top of their foot, and it still accounts for the top hit on my website. The cover illustration is taken from Dr W. Metsaars, published in Dutch, although the text can be translated into English with Google Translate on some computers. (Accessed April 2025)
The Condition
Names given to this condition include dorsal spur, exostosis, and tarsal boss. This latter term can mean a knob or stud or other circular rounded protuberance.
The foot bump condition causes pressure on the top of the foot due to changes around the middle bones, also known as the tarsus. Conditions associated with the bump include the common ganglion, which is soft, but bone can still give rise to problems below this type of swelling. Look at the picture of a female foot to identify the problem (source: Bawa 2016).
Don't Confuse the Bump with a Ganglion
Is it painful?
Is it soft or hard?
Is it a different colour from other foot skin?
Have you had a recent injury to the area?
Hard Versus Soft Foot Bump
The colour of the skin can also help. If it is very red and inflamed, the body is reacting to pressure over the site. If pain increases or is not helped by painkillers, seek help if you have had an injury, or ask a professional for assistance.
The bump does not mean you have arthritis, which is a medical condition, but you may have elements of what we now call arthrosis, wear and tear only, and it can be minor.
Bone spurs can occur in any bone, but they’re most commonly associated with joints. Osteoarthritis can cause bone formation in the tarsus (midfoot). Inevitably, this caused pain in some shoes.
(Qu. 1) ‘I have a small pain in the top of my foot just below my toes. I get a sharp pain in the centre of the foot, that is, well, I can't move for just a matter of seconds. It happens if I move my foot wrong, but I'm not sure how to explain that. It feels like being punched. The pain in the right foot, makes walking uncomfortable, however especially now that the weather has gotten warmer I will be doing more walking. I walked last night for over an hour. My foot is sore today; however, I can still get up and walk around my office as needed. Any suggestions or thoughts? Thank you so much.’
(Ans.1) ‘You could try icing it when it bothers you. Maybe go to a massage therapist.’
(Ans.2) ‘I have one too! Sometimes, if it gets bothered by a shoe or too much walking, I spend some time off the foot or put some ice on it. Hope that helps!’
(Ans.3) ‘There is not a lot that can be done for this non-surgical, as it is a bony mass. Try wearing loose-fitting shoes, as tight shoes would tend to aggravate it. Also, consider placing a pad on top of the deformity to help reduce stress and strain on the area with the compression that irritates the nerve.’
An online medical doctor (US) also responds, so this must be good.
‘Hello, make sure the shoes are wide in the toe and have good heal support. Use Spenco insoles which you can get in any shoe store. These are ultra thin but absorb over 90% of any impact. This might or might not be just in the feet, so when you can afford it you need to see a podiatrist or a physical medicine and rehabilitation specialist to see where the actual focus of strain is...I prefer the later because even a lower spine problem can affect the feet and cause pain. And vica versa.
Online can be helpful, but it is challenging to provide genuine help when one actually fails to understand the problem.’
Good or Bad Foot Bump Advice?
Well, the information, while helpful, can be misleading, but there are some good bits worth highlighting.
The patient
The person writing in gives us a hint—sharp pain with shoes. Foot movement causes discomfort, and the pain level is described as ‘punched’. Walking is uncomfortable and sore, and she is likely to use her feet more as they become warmer. One key piece of evidence could relate to an irritated nerve. The pain is momentary and stops her from moving.
What about advice from Answers 1-3
Answer 1: Ice is always helpful, but it will only settle discomfort due to inflammation if it is minor. If it is nerve pain, ice will play a minor role.
Answer 2. The idea of reducing walking is, at the same time, only a temporary measure.
Answer 3 sounds more intuitive. Footwear loosening is good, and I like the pad. So, it’s time to look out for a YouTube video. Oops, there aren’t any! YouTube is full of promoting practice visits; you don’t want to do this unless you need to. The person answering 3 believes that sometimes surgery is required. This is true, but getting that diagnosis right is vital. But what about the doctor? He must know as he is a medical doctor. It is okay to talk about shoes and make them wide. That sounds fair advice, but why not focus on the design of the top of the shoe?
This is where the problem lies ‘...Use Spenco insoles, which you can get at any shoe store. These are ultra-thin but absorb over 90% of any impact...’
Oh dear, someone does not understand the problem. Put an insole in the shoe, even if it is ultra-thin, and you will make the shoe tight, and the bump will hurt more! Okay, if in doubt, avoid the question entirely, doctor, but I like your advice about seeing a podiatrist. Hey now why chuck spine in there, that is scare mongering!
Sometimes, medical doctors do not know as much about feet as you think. It’s true, as many of my GP doctor friends admit. Online advice can be helpful, but it is difficult where that helps, even if well-meaning fails to address the problem. Some of the lay ideas, on the other hand, were reasonable. Patients' own experiences or journeys can be enlightening, and they can deal with practical solutions.
Heredity
Some people have the bump; others do not, so there is a hereditary feature in its appearance. My mother and I do not have one; my father and sister do. My wife does not have one, but one daughter does. The first anyone knows about the bump is from a shoe, which inevitably rubs. Some consider the bump due to a high arch foot, but this is not an exclusive club. Some think that at one point, there is movement during walking of the two bones that are involved in the joint. Whatever happens, bone spurs stick up and can irritate a nerve, or the skin becomes red and sore. A small sac of fluid (bursa) can form, and this is often called a ganglion. A balloon-like appearance arises when pressed and feels spongy.
Use a bible?
Some say hitting it with a Bible would NOT be a good idea. Hitting the foot may cause deep bruising or even a bone fracture. The idea was to burst the lining so the fluid, which is a clear gel-like substance, would be released. The lining of the ganglion is very active and can reform, and indeed, even if removed, can recur. However, a bump may not be that simple.
The following conditions can be considered.
Arthrosis, or joint surface damage.
Tendon pain is often associated with overuse.
Nerve pain
Ganglion
Bursa
A hard bone bump is also known as a spur.
Gout has been recorded, but it is not that common in the midfoot, so it can be set at a lower priority.
First, look at the appearance. The top of the foot will have a bump above the arch, and it can be tender to the touch, which is worse in some shoes.
The main aim is to relieve pressure, so it comes down to shoe selection and what you can do to the shoe to make matters more comfortable. Remember that the shoes' lacings can be too tight, or the cut of the shoe places too much pressure where it is tender.
Self-help Remedy For a Foot Bump Problem
Protect the skin from pressure. The layperson’s number 3 answer recommended this.
Use a felt pad with a cavity over the bump. If this works, the pad can be converted so that it sticks to the skin or inside the shoe under the tongue.
Select shoes with a lower heel so that the arch does not bend, as the joint will open more in high-heeled shoes.
The quarters (where the laces run through the eyelets) should not be closed up too tightly, and a cushioned tongue in shoes will be better tolerated (see picture c/o www.footeducation.com)
You can make your soft tongue using an adhesive dressing, such as a cavity-type pad fashioned from a square felt or foam. See the self-help sheet to make a felt pad (click here)
In general, local protection and footwear selection to avoid pressure over the bump will allow the area to settle. Unfortunately, if you have a shape that will not go away, you will have to compromise. This can be tough for those who like fashionable shoes.
Seeking Surgery
It's not perhaps where you want to go, but sometimes surgery is the best way to resolve matters permanently. You should seek out a foot surgeon. Here’s a summary of my experience and some things I would tell a patient before surgery.
An operation
The scar line is essential, so where the skin is cut can be a problem.
The bone is shaved down. If you are under 20, reoccurrence can arise because young people can regenerate bone. This might happen more readily if there is greater movement after surgery, as it can all start again, or if insufficient bone is removed.
Although bump surgery can be very effective, wounds can take time to heal. The skin will recover from 10-21 days before it is relatively strong enough to get back into shoes. Sensations may vary after surgery, including numbness or local sensitivity.
The good news is that the surgery works and is effective.
The bad news is that the joint may be less stable, and if you have existing degeneration in the joint movement, making the joint freer may worsen matters. This means a second surgery to stiffen and fix the problem, which does not happen very often.
Thanks for reading Foot Bump on Top of the Foot by David R. Tollafield
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