The right instep pain may be related to the following causes: 1. It may be caused by trauma. The former will often cause local soft tissue contusions or comminuted fractures, while the latter will lead to some local avulsion fractures, which will cause pain. 2. There may be tendon sheath cysts. This disease is often seen in patients with overuse of the foot, or the dorsum of the foot cold, which leads to cysts in the tendon sheath of the dorsum of the foot, mainly in the dorsum of the foot there is an oval swelling protruding from the skin, and there will be obvious pain when the patient extends his toes. 3, there may be fatigue fractures of the foot. This condition is often seen in patients with long distance walking or running, and is very common among active military personnel or long-distance runners, where excessive activity leads to fractures of the metatarsal bones in the front of the foot, which in turn causes pain in the back of the foot.