Intermetatarsal Bursitis
What is Intermetatarsal Bursitis
Intermetatarsal bursitis is controversial:
- Some studies indicate that the inter metatarsal bursa does not exist.
- Some suggest that inter metatarsal bursitis occurs as an isolated problem.
- There are others that say that intermetarasal bursitis exists in combination with an interdigital neuroma referred to as a “bursal- neuromal complex”(2).
Similar to a neuroma, bursitis often presents as pain on the ball of the foot.
Neurological symptoms are less common with bursitis but can also occur as the enlarged bursa can push on the common plantar nerve resulting in burning, tingling, numbness and pain in the region of the forefoot (1).
What is the Cause of Intermetatarsal Bursitis?
The exact cause of interdigital bursitis is unclear.
It is thought that inter metatarsal bursitis, similar to a neuroma, is the result of compression trauma of the intermetatarsal bursa.
(see the diagram below of a cross section of the forefoot).
The irritation of the bursa is thought to be made worse with:
- Tight fitting footwear
- Hypermobile joints
- Digital deformities (clawtoes or (Hallux valgus) bunions)
- A flat foot
- A high arched foot
Diagnosis of Intermetarasal bursitis
Diagnosis is usually based or symptoms and a complete assessment of your foot and ankle.
At the Foot an Ankle Centre we are able to provide additional information about the presence of intermetatarsal bursitis with ultrasound imaging.
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Typically bursitis, similar to a neuroma, will present as a compressible mass between the web space as shown in the picture above and the video below. Generally an enlarged bursa will be more compressible than a neuroma
Treatment of a Intermetarsal bursitis
Treatment aims to reduce the irritation of the bursa and also offload the forefoot to prevent its re-occurrence.
Reduction of the inflammation of the bursa can include
- Ultrasound guided injection therapy
Offloading the forefoot can be achieved with
- Shoe stretching and modification (rocker sole modification)
- Metatarsal domes
- Custom made Orthotics with a metatarsal dome incorporated into the design
What else could it be? (differential diagnosis)
Other problems that can cause similar pain to intermetatarsal bursiits include:
Bursal Neuromal Complex
Friebergs infraction
Metatarsal stress fracture
The Ankle, Foot and Orthotic Centre’s Northcote Podiatrists can help you with all lower limb complaints, including a intermetatarsal bursitis. Make an appointment to get your foot and ankle pain under control.
Expert Podiatrists for the treatment of Intermetatarsal bursitis. servicing the areas of Northcote, Thornbury, Fitzroy, North Fitzroy, Carlton, North Carlton, Alphington, Fairfield, Brunswick, Coburg and Preston
Call The Ankle Foot and Orthotic Centre for diagnosis and advice on professional management and treatment options.
References
- Bossley CJ, Cairney PC. The intermetatarsophalangeal bursa–its significance in Morton’s metatarsalgia. J Bone Joint Surg Br. 1980;62-B(2):184-7.
- 4.Cohen SL, Miller TT, Ellis SJ, Roberts MM, DiCarlo EF. Sonography of Morton Neuromas: What Are We Really Looking At? J Ultrasound Med. 2016;35(10):2191-5.
- Zanetti M, Weishaupt D. MR Imaging of the Forefoot: Morton Neuroma and Differential Diagnoses. Seminars In Musculoskeletal Radiology. 2005;09(03):175-86