# Midfoot pain > Midfoot pain is pain in the arch area of the foot, between the heel and the toes. Common causes include arthritis and injuries to ligaments or bones. Stiff, supportive shoes, insoles and easing off activity are the usual first steps, and a podiatrist can help find the cause. Guide in [Heel and arch pain](https://footanklelowerlimb.com.au/learn/topics/heel-and-arch-pain), from Foot Ankle Lower Limb: https://footanklelowerlimb.com.au/learn/midfoot-pain Reviewed by Andrew Schox, BSc(Hons) PGradDipPod MPod (Podiatrist) on 27 October 2026. Next review by 27 October 2027. - **It's pain in the arch area,** between your heel and your toes, often felt on top of the foot. - **Arthritis is a common cause,** especially over 50, but a twist, fall or blow can also be behind it. - **Don't assume it's just a sprain:** some midfoot injuries are easy to miss and need a proper check. - **Stiff, supportive shoes and easing off aggravating activity** are the usual first steps. - **Some signs need prompt care,** and they're listed at the end. ## What is midfoot pain, and how common is it? Midfoot pain is pain in the arch area of your foot, between the heel and the toes [1]. It affects 20% of people over 50, more women than men, and more people in manual jobs [1]. Midfoot osteoarthritis (wear-and-tear damage to the joints that form the arch) is the most common cause in this age group [1][2]. It helps to note where the pain sits (top of the foot, in the arch, or on the inner or outer side) and what brings it on, such as walking, standing, a twist or a fall. That gives a podiatrist a head start in working out the cause. ## What can cause midfoot pain? Several things can, and they tend to feel a little different: - **Osteoarthritis** causes an aching pain with walking and standing. There may be a bony lump on top of the foot and soreness where shoes press [1][3]. - **Ligament injuries**, including a Lisfranc injury (damage to the ligaments that hold the midfoot bones together), usually follow a twist, a fall or a blow to the top of the foot. They can feel like an ankle sprain and are often overlooked [1][4]. Bruising on the sole is an important sign [5]. - **A stress fracture** causes very localised pain over one spot on a bone [1]. - **Tendon pain** is sore when you lift your foot or toes against resistance [3]. - **Gout and other inflammatory arthritis** can make the foot painful and inflamed [1]. - **Charcot foot** (a foot damaged and inflamed because of nerve damage, mostly linked with diabetes) looks swollen and warm [1][6]. Don't assume midfoot pain after a twist or fall is just an ankle sprain: it can be a ligament or bone injury [7]. See a podiatrist or your GP if the midfoot is tender or painful when squeezed. If you can't put weight on the foot after an injury, see your GP or a podiatrist the same day. ## How is the cause found? A podiatrist starts with your story: how the pain began, your usual footwear and activity, and any diabetes, numbness or joint conditions. They'll watch you walk, compare both feet, press on painful areas and may squeeze the midfoot [8][9][7]. That's a normal part of assessment. For pain that came on gradually, the diagnosis is mostly made from your history and examination [3]. After an injury or overuse, X-rays are usually the first images, often taken standing and of both feet [9][7]. X-rays can miss a Lisfranc injury, so a CT or MRI scan may follow if it's still suspected [7]. A normal X-ray doesn't rule one out [5]. If an X-ray is arranged, ask whether it will be taken standing. ## What helps first? Simple care is the first step [3][6]: - **Choose a fairly stiff, supportive shoe** with a firm sole, laced securely [8]. Avoid flat slip-on shoes [3]. Roomy, low-heeled shoes with soft soles also help [10]. - **Cut back on what aggravates it** for now. - **Try insoles.** They can ease pain by limiting movement across the midfoot joints. They don't cure the problem and work best in supportive shoes [8]. - **Ask a pharmacist** about pain relief such as paracetamol. A podiatrist or physiotherapist can add exercises, taping or orthoses (shoe inserts), chosen together with you [6]. Most of this rests on guidance rather than strong trials, so how much each step helps isn't clear yet. Stable Lisfranc injuries in athletes did well without surgery [11]. > [!tip] Try this > For pain on top of the foot, rest and raise it. Put an ice pack wrapped in a towel on the sore area for up to 20 minutes every 2 to 3 hours. These steps are for pain without a significant injury. If you can't put weight on the foot after an injury, or you think a bone may be broken, see your GP or a podiatrist the same day rather than treating it yourself. ## What helps if that isn't enough? If simple care hasn't helped, ask your podiatrist or physiotherapist whether referral to an orthopaedic service is right for you. Referral is usual when an injection is being considered, the cause is uncertain, or pain is severe or getting worse [6]. For midfoot arthritis, injections, orthotics and joint fusion surgery are widely used, but little research backs how well they work [12]. Lisfranc injuries that are unstable or displaced are often fixed with surgery [5]. Delay in treating a Lisfranc injury is linked with more complications, so don't put off review if pain persists after an injury [4]. If surgery is planned, ask what it involves and how long you'll need to stay off the foot. ## Will it get better, and how can I stop it coming back? Athletes with stable Lisfranc injuries treated without surgery mostly returned to sport within about 6–10 weeks [7]. How long other causes take, such as midfoot arthritis, isn't clear yet, so ask your podiatrist what to expect. No approach has been shown to prevent it returning. Strengthening exercises for the foot muscles may reduce the chance of re-injury, though how well they work for midfoot arthritis isn't firmly established [1]. Support with weight management is part of care [1], and it's worth asking your doctor if that suits you. Keep wearing supportive, firmly laced shoes [8], and build back to sport or heavy activity gradually, following your clinician's advice. See a podiatrist or your GP if pain keeps coming back or doesn't improve, because missed injuries can lead to persistent pain and arthritis [8]. ## When to see a podiatrist Midfoot pain is hard to work out on your own, and some causes need prompt care. See your GP or a podiatrist the same day if: - you can't put weight on your foot after an injury, or there's bruising on the sole or marked swelling [5]; - you have diabetes or reduced feeling in your feet and notice a wound, sore, blister, new pain, heat, redness, swelling or colour change, because foot problems can worsen within hours [13][6]; - your calf is hot, swollen and painful (being in a cast raises the risk of a blood clot) [8]; - you have sudden severe pain or numbness in a leg or foot. For urgent advice when it isn't an emergency, call healthdirect on 1800 022 222 (24 hours a day), or go to a Medicare Urgent Care Clinic. Call 000 and ask for an ambulance if your foot or leg suddenly turns cold and pale or blue, with pain or numbness, or you can't move it; a bone, tendon or joint is exposed through an open wound [14]; or you have chest pain, sudden severe breathlessness or you cough up blood. Go to the nearest emergency department if your foot is badly out of shape after an injury [14][15]. See a podiatrist or your GP if pain follows an injury, is very localised over one spot on a bone (a possible stress fracture, where delay can lead to poor outcomes) [16], comes with numbness, tingling or weakness, or is severe, getting worse or not improving with simple care. ## Common questions ### Can I walk on a painful midfoot, or should I rest it? For mild pain without a significant injury, it can help to cut back on what makes it worse and wear supportive shoes. After an injury, how much weight is safe depends on the cause, so your clinician will guide you. For a stable ligament injury, experts support putting weight on the foot as tolerated, with regular check-ups. ### Why is my midfoot pain worse after standing or walking for long periods? Your midfoot takes the load of your body weight through the arch when you stand and walk. Age, changes in body weight, pregnancy and tired muscles can add to that load and are linked with more midfoot pain. If it's regularly worse after long periods on your feet, a podiatrist can look for the cause. ### Is midfoot pain a sign of arthritis? It can be, especially if you're over 50 and the pain is an ache with walking and standing. But injuries, stress fractures and tendon problems can feel similar. It's best to have midfoot pain assessed rather than assuming, so the cause can be found and the right care started. ## Further reading - [Midfoot pain on Clindice](https://clindice.com/midfoot-pain) - [Midfoot osteoarthritis](https://www.kentcht.nhs.uk/leaflet/midfoot-osteoarthritis/), NHS - [Metatarsal stress fractures - aftercare: MedlinePlus Medical Encyclopedia](https://medlineplus.gov/ency/patientinstructions/000553.htm), MedlinePlus - [Midfoot arthritis - midfoot fusion and arthrodesis surgery](https://www.wsh.nhs.uk/CMS-Documents/Patient-leaflets/TraumaandOrthopaedics/6261-1-Midfoot-Arthritis-midfoot-fusion-and-Arthrodesis-Surgery.pdf), NHS - [Midfoot fracture | Fracture Clinic | Royal Cornwall Hospitals NHS Trust](https://fractureclinic.royalcornwallhospitals.nhs.uk/foot-injuries/midfoot-fracture/), NHS - [Purchasing Off The Shelf Orthotics to Manage Common Foot Pains](https://dchft.nhs.uk/leaflets/purchasing-off-the-shelf-orthotics-to-manage-common-foot-pains/), NHS ## Sources 1. Current and future advances in practice: mechanical foot pain · Halstead J, Munteanu SE · Rheumatology Advances in Practice · 2023. https://doi.org/10.1093/rap/rkad081 2. Midfoot osteoarthritis · Kent Community Health NHS Foundation Trust · 2025. https://www.kentcht.nhs.uk/leaflet/midfoot-osteoarthritis/ 3. Foot and Heel Problems - South & West · South & West. https://southwest.devonformularyguidance.nhs.uk/referral-guidance/western-locality/musculoskeletal/foot-and-heel-problems 4. Functional outcomes and complications following surgical management of neglected Lisfranc injuries: A systematic review and meta-analysis · Sharma S, Sen C, Kumar A et al. · Foot (Edinburgh, Scotland) · 2026. https://doi.org/10.1016/j.foot.2026.102283 5. Guidelines for management of confirmed or suspected Lisfranc injuries in ED · NHS. https://www.gloshospitals.nhs.uk/media/documents/Foot_Lisfranc_injuries_TFPIf8X.pdf 6. East Sussex MSK Community Partnership · NHS. https://eastsussexmsk.nhs.uk/wp-content/uploads/2025/10/Foot-Ankle-Triage-Guidance-2025.pdf 7. Diagnostic evaluation and nonoperative management of Lisfranc injuries in athletes · Semelsberger SD, Boggiano VJ, Webber K et al. · Knee Surgery, Sports Traumatology, Arthroscopy · 2026. https://doi.org/10.1002/ksa.70244 8. Midfoot problems · Chelsea and Westminster Hospital NHS Foundation Trust. https://www.chelwest.nhs.uk/your-visit/patient-leaflets/surgery-services/midfoot-problems 9. Foot and Ankle Conditions: Midfoot and Forefoot Conditions · Edenfield KM, Michaudet C, Nicolette GW et al. · FP Essentials · 2018. https://pubmed.ncbi.nlm.nih.gov/29381043/ 10. Pain in the top of the foot · NHS. https://www.nhs.uk/symptoms/foot-pain/pain-in-the-top-of-the-foot/ 11. Return to sport following Lisfranc injuries: A systematic review and meta-analysis · Robertson GAJ, Ang KK, Maffulli N et al. · Foot and Ankle Surgery · 2019. https://doi.org/10.1016/j.fas.2018.07.008 12. Midfoot and forefoot osteoarthritis · Kalichman L, Hernández-Molina G · Foot (Edinburgh, Scotland) · 2014. https://doi.org/10.1016/j.foot.2014.05.002 13. Diabetes - I’m worried about my foot – is it serious? · The Queen Elizabeth Hospital King's Lynn NHS Foundation Trust · 2025. https://www.qehkl.nhs.uk/services/diabetes/im-worried-about-my-foot/ 14. Ankle or foot injury (acute) · NSW Government. https://www.health.nsw.gov.au/outpatients/referrals/Pages/foot-injury-adult.aspx 15. Orthopaedic emergencies · NSW Government. https://www.health.nsw.gov.au/outpatients/referrals/Pages/orthopaedic-emergencies.aspx 16. The challenge of managing mid-foot pain · Baquie P, Fooks L, Pope J et al. · Australian Family Physician · 2015. https://pubmed.ncbi.nlm.nih.gov/25770574/ --- This page is general information, not a diagnosis or a treatment plan for you. For advice about your own feet or legs, see a podiatrist or your doctor. In an emergency, call 000.