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:

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.

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

Neuroma Orthotic

What else could it be? (differential diagnosis)

Other problems that can cause similar pain to intermetatarsal bursiits include:

Bursal Neuromal Complex

Mortons Neuroma

Interdigital Neuroma 


Plantar plate pathology

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.



  1. Bossley CJ, Cairney PC. The intermetatarsophalangeal bursa–its significance in Morton’s metatarsalgia. J Bone Joint Surg Br. 1980;62-B(2):184-7.
  2. 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.
  3. Zanetti M, Weishaupt D. MR Imaging of the Forefoot: Morton Neuroma and Differential Diagnoses. Seminars In Musculoskeletal Radiology. 2005;09(03):175-86