The possible causes of instep pain include strenuous exercise, improper shoes, trauma, foot lesions, and diseases in other parts of the body. 1. Strenuous exercise: it may be a long period of inactivity and sudden strenuous exercise, which causes the muscles of the instep to be stimulated adversely and instep pain occurs. 2. Inappropriate shoes: It may be due to the inappropriate size of shoes, coupled with standing or walking for too long, can also cause the symptoms of instep pain. 3. Trauma: If the back of the foot suffers from trauma, contusions, fractures and other localized injuries, it may also cause instep pain. 4. Foot lesions: flat feet, inversion deformity of the little toe, metatarsophalangeal arthritis of the little toe, tendonitis, tenosynovitis, fasciitis, peripheral neuritis, osteomalacia of the foot, as well as various infections of the foot, etc., which may also cause dorsal foot pain. 5. Other parts of the disease: gout, lumbar disc herniation, osteoporosis, pear-shaped muscle syndrome, etc., may also cause symptoms of instep pain. There may be other reasons for the back of the foot pain, it is recommended to go to the regular hospital in a timely manner to improve the relevant examination, to clarify the cause of the disease, under the guidance of the doctor to carry out targeted treatment or treatment.