Right (or Left) Foot Swollen on Top: Why & What to Do?

Case 1: One swollen and painful foot on top

Do you also experience pain along with the swelling?

In this case, it is more likely that an injury is the cause of the swelling on the foot, especially if you’ve had trauma (fall, impact, twisted foot, etc.):

• A simple bruise
• Injury to a ligament, stretched or torn: ankle sprain or sprain in another foot joint
• Fracture of the foot. In this case, walking is often difficult.

Other conditions or problems can also cause painful swelling on the top of the foot without a fall:

• Tendonitis/tendinopathy (inflammation of a foot tendon), especially if you’ve increased the time spent on a new physical activity too quickly, like running or prolonged standing.
• Osteoarthritis or arthritis
• Gout
• Bursitis
• Infection (in this case, you probably have other symptoms: fever, wound, red and warm foot, etc.).

If you haven’t had an accident or impact on the foot, the pain may simply be related to swelling compressing the skin and other tissues of the foot. In this case, the possible causes are the same as those for a foot swollen on top without pain (see below).

Case 2: One swollen foot without pain

Your foot is swollen, but you have absolutely no pain?

Neither at rest, nor while walking, nor when moving the foot?

In this case, the most probable causes of this swelling are:

1. Water retention (edema): simply having a swollen foot due to an accumulation of fluid, without a specific cause! It’s more common to have both feet affected, but not necessarily.
2. Allergic reaction or insect bite.
3. Venous insufficiency: a blood circulation problem.
4. Lymphedema: swelling of the foot due to a malfunction of the lymphatic system.
5. Medications: side effects of certain medications causing foot swelling, such as antihypertensives or anti-inflammatories.
6. Varicose veins: dilated and swollen veins in the foot.
7. Deep vein thrombosis (DVT): formation of blood clots in the deep veins of the foot. Often following surgery or in the case of prolonged bed rest.

Pain is just one of many indicators among several others that help determine the cause of the pain. It can provide clues, but it’s not a sufficient criterion!

Case 3: One swollen foot with tingling

Pain, tingling, and swelling on the top of the foot may be a sign of tarsal tunnel syndrome.

It’s somewhat similar to the better-known carpal tunnel syndrome.

The tarsal tunnel is a narrow passageway inside the ankle, between the bones of the foot and the ankle. It houses several tendons, ligaments, and the posterior tibial nerve.

When the posterior tibial nerve is compressed or irritated inside the tarsal tunnel, it can cause these symptoms.

This is the most likely cause in the case of swelling and pain with tingling on the top of the foot. However, likely does not mean certain!

Case 4: Swollen foot on the top and outer side

If your foot is swollen on the outer side as well, it may suggest all the pathologies mentioned earlier!

It’s often more common: the swelling easily extends to the rest of the foot, regardless of its origin.

Why does the foot sometimes swell more on the top than on the side?

All the pathologies I have discussed so far can also lead to swelling of the entire foot, including the side.

So, why does the foot swell just on the top sometimes?

One possible reason is anatomical. The top of the foot consists of a relatively thin layer of soft tissues, including the skin, tendons, ligaments, and muscles.

In comparison, the sides of the foot often have more subcutaneous fat and a greater variety of bony structures.

Fluid can more easily seep into these soft tissues.

Could it be cancer?

I’m probably like you, even though I have a background in the health sector: I often tend to think of the worst when I (or one of my children) experience sudden, unfamiliar pain.

These are cognitive biases that lead us to immediately think of serious conditions such as cancer when faced with less severe symptoms, like simple swelling.

Since severe cases of diseases, like cancer, are often more publicized and discussed, they are more mentally accessible, which can lead us to consider them more likely.

Moreover, once we have an idea in mind, we tend to seek information that confirms it rather than contradicts it. If we are worried about a serious condition, we might ignore evidence suggesting otherwise.

The probability that your suddenly swollen foot, without any other associated symptoms, is due to a tumor or cancer is close to 0.

Could it be hypertension?

The precise location of the pain (here, on the top of the foot) is not a very good indicator to pinpoint the exact cause. Not even the fact that only one foot is affected.

High blood pressure, in itself, generally isn’t a direct cause of only one foot being swollen on the top. Uncontrolled hypertension over a long period might eventually contribute to circulation problems, but both feet are often affected.

It is impossible just by looking at your foot to determine if it is due to hypertension or not, although it is not the most likely cause.

When should you consult a doctor due to swelling on the top of the foot?

Often, while browsing the internet or reading magazines, you’ll come across articles that say something like “if in doubt or concern, consult your doctor.”

My goal here is not to repeat this formula read everywhere, even though I understand that many health and medical writers use it. But to be as precise as possible to advise you on when to consult or not.

1. In the vast majority of cases, swelling in one foot without any other symptoms does not require consultation.

You can simply bring up the topic with your primary care doctor during a next scheduled visit for something else, if it still concerns you at that time.

2. Other symptoms associated with this swelling of the foot might, on the contrary, encourage you to consult, without urgency.

These symptoms include:

• If you have great difficulty walking by putting weight on the foot, or if you are unstable, or if walking is extremely painful;
• If you have unexplained fever not related to an ongoing illness like the flu or a severe cold;
• If your skin has rapidly changed color, become purplish, or very red;
• If you have lost a lot of weight recently or feel really unwell in general.

Can the swelling go away on its own?

Yes, absolutely. As a physical therapist, I have numerous examples of conditions where foot swelling resolves on its own over time without specific treatment. And patients for whom it happened that way 🙂.

For example, after a ligament rupture in the ankle (grade 2 or 3 sprain). Or in the case of water retention, often more pronounced in the summer.

So, keep hope: if you have swelling in the foot (even without an identified cause), it can go away on its own with time.

Now, are there things one can do to speed up the disappearance of foot swelling, regardless of the underlying cause?

How to reduce foot swelling?

Depending on the cause of your foot swelling, there may be specific treatment.

For example, in the case of rheumatoid arthritis, a rheumatic disease causing joint inflammation (= arthritis).

But in the vast majority of cases, medical, non-medical, or surgical treatments for foot swelling are the same.

I have already dedicated a full article to this topic that I invite you to read: how to reduce swelling in a swollen ankle (or foot)?

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Here’s what I wanted to tell you about this! I wish you a very good recovery! Do you have any comments or questions? Your comments are welcome 🙂 !

You may also like:

• How Long Does a Sprained Ankle Stay Swollen? 
• Common Causes of Ankle & Foot Swelling

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