Walking pain and swelling of the instep may be caused by trauma, bunion, gout and other diseases. 1. Trauma: If the back of the foot has recently been crushed, crushed or sprained, resulting in dislocation or injury to the bones, joints and ligaments of the foot, causing blood vessel rupture and the formation of a hematoma, then the back of the foot will easily become painful and swollen. 2. Bunion: The cause of bunion is still unclear, and may be related to heredity, bad shoe-wearing habits, congenital foot structure abnormalities, rheumatic diseases and other reasons. Typical symptoms are bunion deformity, redness, swelling and pain, especially when walking, which will aggravate the discomfort, and may be manifested as walking instep pain and swelling. 2. Gout: Studies have shown that the causes of this disease include the intake of high-purine foods, hyperuricemia, excessive alcohol consumption. Secondly, it can also be secondary to hypothyroidism, psoriasis and other diseases. Gout often starts suddenly at a certain moment, and then the affected joints of the feet will show redness, swelling, heat and pain, so some patients will have pain and swelling in the back of the feet. 4. Other: clinically, it can also be seen in tendon sheath cysts, rheumatoid arthritis, diabetic foot and other diseases. It is recommended that patients with pain and swelling in the back of the foot should go to the hospital to complete the relevant examinations to clarify the specific causes.