Soft, Painful, Small, Hard Lump on Top of foot: Causes, Symptoms, Treatments

It is common for a lump to appear on the top of the foot. Such a lump may develop over time or appear as if from nowhere.

Lumps are common indications of malignancy or cancer. Even so, cancer rarely starts on the foot. Other causes of lumps such as cysts and arthritis are likely to be responsible for lumps on legs.

Experts always insist on the need to understand the cause of a lump. The same can be said about the importance of knowing the symptoms of a harmful lump.

Should treatment be necessary, your doctor will suggest the best options.

Lump on top of foot types

In most cases, a lump on top of foot will fall in either of the following categories:

  • Bone spur – a bone spur is typically an overgrowth of a normal bone. Bone spurs mostly occur at joints, such as on shoulders, spine, feet and hands. Normally, it is not supposed to be painful. The problem is that it keeps rubbing against other bones or soft tissues. This often leads to wearing and tearing, which causes pain. The top of the foot near the ankle is a common place that bone spur lumps occur.
  • Cystic lumps – a cyst forms when fluid, gas or pus collects in a sac under the skin. Cysts form hard painless lumps. It is common to have a hard painful lump under armpit or on scalp as a result of cyst formation. Irritation and rubbing against shoes can make cystic lumps painful. In most cases, cystic lumps resolve on their own. They can however be surgically removed or drained.

These are the main categories into which lumps on top of foot will fall. However, some lumps will fall into different categories as we shall see.

Hard lump on top of foot due to ganglion cyst

A hard lump on top of the foot could be a ganglion cyst. Ganglion cysts are filled with a thick, sticky fluid. They originate from a joint capsule and are a common cause of lump on your wrist.

The actual causes of ganglion cysts remain unknown. However, they are noted to develop after repetitive trauma. These cysts vary in sizes. They may heal on their own, just to come back later.

Ganglion cysts do not cause many noticeable symptoms. In fact, you may not notice its existence until it forms a mass big enough to be seen. As it grows larger, the mass may grow into the path of a nerve. This will lead to dull pain, tingling or burning sensation. Constant friction with footwear is also likely to cause irritation and therefore pain.

A doctor can identify a ganglion cyst after physical examination. An X-ray or imaging tests may be considered to confirm diagnosis.

If the cyst is not causing pain, discomfort or irritation, it can be left alone. Some of them do decrease in size and even disappear on their own. A hard painful ganglion cyst can be removed by draining and injecting it with steroids. The drawback with this treatment approach is that most cysts tend to come back. Surgery is a much better alternative, especially when other treatments have proven not effective. Surgically removed ganglion cysts rarely come back.

Painful lump on top of foot caused by bunions

Some people develop a painful lump on top of the foot caused by bunions. A bunion is a bump that occurs on the base side of the big toe. It forces the big toe to bend towards the second toe, rather than being straight.

The actual visible bunion is usually not the main problem. The actual complication lies inside the top of foot, where the big toe is connected to the bones on top of the foot.

Bunions mostly occur in people who are genetically predisposed. The condition progresses over time and with time become more painful. Many people tend to associate bunions with ill-fitting foot wear. Ill-fitting foot wear may encourage the formation of bunions but will not cause them.

Bunions are diagnosed through physical examination. An X-ray may be necessary to check the extent to which the deformity that has occurred inside the joint.

While bunions are not serious medical concerns, they usually cause discomfort and pain. Furthermore, they keep getting bigger with time. Early treatment is therefore helpful. Most treatment options for bunions seek to ease pain and discomfort but not reverse the condition. They include:

  • Medications – anti-inflammation medications can be used to ease pain and inflammation. In this case, non-steroid medications are used. Steroid-based injections are only considered cyst-like inflammations on the bunion.
  • Pads – pads can be placed on top of the bunion to reduce rubbing with foot wear. They also reduce pain associated with sore bunions.
  • Orthotic treatment – your doctor may opt for orthotic devices in attempt to correct the deformity.
  • Lifestyle changes – since bunions are progressive, modifications in lifestyle will greatly reduce the extent of damage and rate of progression. You can for example consider wearing shoes with a wide area at the front. Activities that require standing for long periods or walking for long distances should also be reduced.
  • Surgery – surgery is the only treatment option that seeks to correct the disorder that causes bunions. Your doctor will suggest the best surgical approach, mainly based on X-ray reports.

Other causes of lumps on top of foot

A small, hard, painful or soft lump on top of the foot can also be caused by:

Muco-cutaneious cyst

This forms a small lump on top of the foot that resembles a nodule. It is very common on the joint next to the toenail. Muco-cutaneious cysts feel rubbery to touch but are firmly fixed. Constant rubbing with foot-wear often causes the cyst to break open and ooze a clear fluid. The cysts often return once broken skin heals. Surgical removal is perhaps the best treatment for these cysts. It can be done in a local clinic by a doctor.

Metatarsal –cuniform exostosis

Metatarsal –cuniform exostosis occurs on top of foot near the middle region. It develops after occurrence of bone spur inside the top of foot. It is almost similar to a ganglion cyst. In fact, both form due to jamming of bones in a joint. Metatarsal –cuniform exostosis is best removed through surgery. Pads to protect the area from friction can also be considered.

Degenerative arthritis

A degenerative arthritis lump can develop on top of foot. In most cases, it occurs at the joint at which the big toe is attached to the foot. Arthritis lumps are treated with orthotics and through surgery.

Hammertoe deformity

Hammertoe deformity causes the big toe to be raised at the middle. This encourages rubbing with shoes, which in most cases leads to formation of a callus. The callus can be removed surgically. Soft pads are however mostly used to reduce the rubbing.

Accessory navicular syndrome

Accessory navicular syndrome is a form of a birth defect. It occurs due to the presence of a bony mass inside foot just above the arch of the foot. It is mostly harmless but can cause a painful lump on top of foot. The painful lump will mostly develop due to irritation by shoes or strenuous activities such as walking. People with flat feet are more likely to develop painful lumps on top of their feet due to accessory navicular. Treatment can be done with medications, lifestyle modifications, padding and surgical removal.

Lipomas and fibromas

Lipoma describes small fat deposits that form under the skin. They can lead to formation of soft lump on top of foot. Lipomas can appear anywhere on the skin. They are not harmful and require no special treatment. Fibromas are disorders of the connective tissue. They mostly occur on bottom of the foot but can also develop on top.

Malignant tumors

It is in rare occasions that a hard lump on top of the foot will be due to malignant tumors. Malignant tumors show signs such as:

  • Hard lump
  • Hard, painless and fixed lumps
  • Indefinite increase in mass
  • Swollen lymph nodes; which may cause a painful small lump behind ear or painful lump in groin
  • Weight loss
  • Voice hoarseness
  • Occurrence of lumps in other parts of the body

It is advisable to learn more on topics such as what does a testicular lump look like, breast cancer lumps and how to identify a cancer lump.

Diagnosis and treatment for lump on top of foot

Diagnosis can be done by a doctor through physical examination. In most cases, this will be followed by x-ray imaging. X-rays display the extent of deformity or the origin of a lump on top of the foot.

Treatment depends on how large the lump is and its cause. Non-steroid medications are commonly used to reduce swelling. Steroid-based medications can be injected into a cyst-like lump after draining. In most cases, padding will help avoid rubbing against shoes. You find that most lumps on top of the foot are made worse and more painful by shoes. Orthotic devices keep two bones joined at a joint from jamming. Some are available over the counter.

If the lump is too large or not responding to treatments, it can be surgically removed. Surgical operations not only seek to remove lumps but also correct the bone deformity that may be causing the lump. Your doctor will advise on the best treatment option.

Be sure to make use of correctly fitting shoes. You can even consider custom-made shoes, depending on the type of foot lump you are dealing with.

A sore lump on foot will encourage infections, mostly due to bacteria. Signs of infections include fever, pain, redness, pus formation and swelling. Lump on the neck in a child symptoms are common in advent of infections. The same can be said for people with compromised immunity.