Severe pain on the top of the foot often results from stress fractures or metatarsal fractures, explains FootVitals. Common causes for fractures include repetitive movements, weak muscles, arthritis and injury.
Gout, diabetes and tendonitis, as well as nerve pressure and hormonal imbalances, may also lead to pain on top of the foot, according to FootVitals. Pain in this location is not normal, so sufferers should seek medical attention. After diagnosis, treatments include acetaminophen, ibuprofen or naproxen for pain and inflammation management, along with shoe inserts or other orthotics. A doctor may also recommend changing footwear and limiting activity. Surgery may be an option in severe cases.