There are many reasons for instep pain. The first is caused by trauma. If the instep is injured or the shoes are too tight for a long time, it will cause local damage, resulting in instep pain, and the pain will increase significantly when walking. The second is caused by instep arthritis, such as rheumatoid arthritis, osteoarthritis, etc., because the joints are damaged, it will cause the symptoms of instep pain. The third consideration is gout. As the purine metabolism in the body is abnormal, the uric acid level in the blood is increased, which may cause instep pain. Fourth, local infection should be considered. Pain is caused by the stimulation of inflammatory factors.