It's common to see a bump on the top of the foot. There can be a number of causes. One common cause of the formation of a lump is a #BoneSpur. My name is Dr. Andrew Schneider, and I'm a podiatrist in Houston, Texas. A bone spur on top of the foot gets in the way of certain shoes. Some people aren't even able to wear shoes that cover the spur.
A bone spur is a growth of extra bone. It's most commonly found in areas of pressure or tension. It's easy to forget that bone is living tissue. There's a principle of bone called Wolff's law. It dictates that tension on the bone will lead to a proliferation of bone growth. Put simply when there's tension or pressure on the bone, the bone responds to these forces by creating new bone. This is what forms the bone spur.
When a bone spur forms on the top of the foot, one common place for it to form is at the base of the first metatarsal. I consider that the "apex" of the foot. This is especially true in people with a higher arch. The increased tension in this area can cause the bone spur to form. While the spur itself is not necessarily painful, it does become painful when it's pressing inside a shoe.
The type of shoe matters when it comes to this type of bone spur. A dressier shoe will often put more pressure on this spur causing it to be uncomfortable. If a laced athletic shoe is worn, there's less pressure on the bone spur. In addition, you can change the lacing pattern of athletic shoes to skip the islet around the bone spur. This results in a properly fitting shoe but with pressure relieved surrounding the bone spur.
Treating a bone spur on top of the foot depends on the goals. Whether it is simply to relieve the discomfort that you're feeling or to treat the bone spur itself. The pain can be treated with anti-inflammatory medication or a cortisone injection to reduce the inflammation surrounding the bone spur. Padding and changes in the lacing patterns can be used to reduce the pressure over the bone spur itself. Wearing different shoes, such as those with extra depth, will also reduce the pain of the bone spur.
If none of these are effective in reducing the pain surrounding a bone spur on top of the foot, then the next step is to remove the bone spur surgically. Surgical removal of a bone spur is a reasonably straightforward procedure. An incision is made overlying the bone spur. The spur is identified and removed using surgical instrumentation. The area is then sutured. After surgery, you will be able to bear weight in a surgical shoe immediately. The sutures stay in for approximately two weeks. Once the sutures are out, you can return to shoes once you're comfortable. You can return to full activity as soon as it's comfortable for you, since we're not disrupting the structures of the foot with surgery. Most people find it to be a reasonably easy recovery.