What is it?
A common cause of pain at the ball of the foot can be caused by a condition known as intermetatarsal bursitis. A bursa are small fluid filled sacs that are located near tendons, ligaments, muscles and skin that would otherwise rub directly against the surface of the bone.
They are essential in reducing friction and decreasing the wear and tear between joints. The intermetatarsal bursae are located on the bottom of the foot near the base of the toe.
Due to the high stresses placed on the forefoot, the intermetatarsal bursa can become inflamed.
What are the symptoms?
Common symptoms include:
- Pain while standing on toes
- Pain while walking barefoot or in flat, hard shoes
- Tenderness at the ball of the foot during rest as well as walking
- Forefoot swelling
- Burning/pins and needles in the forefoot
Why did I get it?
Intermetatarsal bursitis can be caused by many factors and is most commonly seen in the active middle aged population.
Most patients with the condition can often present with the following risk factors:
- High arched feet
- Poor or tight footwear
- Poor alignment/biomechanics
- Diminished cushioning at the ball of the foot
- Feet that roll in
- Standing on feet for long periods of time
How is it diagnosed?
Usually, a diagnosis of intermetatarsal bursitis will be made through a thorough history and biomechanical assessment. Sometimes you may be referred for an Ultrasound to confirm the diagnosis and rule out further pathology.
How can I treat it?
Treatment for intermetatarsal bursitis pains are tailored to your individual risk factors. Common conservative treatment options include:
- Rest, ice and elevation for acute cases
- Padding/strapping
- Footwear advice – ensuring shoes are the appropriate width and have an adequate amount of cushioning at the forefoot
- Biomechanical correction
- Custom orthotics
- Corticosteroid injection- if conservative treatment options are unsuccessful
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