Bursitis around the metatarsals of the foot

Small bursae between the metatarsal heads can become irritated when the forefoot is repeatedly compressed or loaded. Narrow shoes, prolonged time on the feet and a rapid increase in impact activity can aggravate the space between the toes. Pain is often felt in the ball of the foot and may worsen in tighter footwear.

A nerve irritation called a neuroma, joint inflammation, a stress injury and thickened skin can cause similar symptoms. The clinician checks the exact site of pain, toe sensation, swelling and how the foot responds to squeezing and weight-bearing. Imaging may help when the examination does not clearly separate these causes.

Try shoes with a wide toe box, secure fastening and enough depth so the forefoot is not squeezed. Reduce running, jumping or long periods of standing until ordinary walking is more comfortable. A soft insole or correctly positioned metatarsal pad may shift pressure, but a pad placed directly under the painful spot can make symptoms worse.

Return to activity in stages and note whether pain appears during exercise or later that day. Persistent symptoms merit a foot assessment to check gait, footwear wear patterns and joint mobility. Treatment should match the confirmed structure because nerve pain and bone stress require different management from bursal irritation.

Seek prompt care if the foot is hot, red, rapidly swelling or associated with fever, a wound or drainage. Urgent evaluation is also appropriate if the foot becomes numb, pale or cold, or if pain after an injury prevents weight-bearing.

Book an appointment if pain continues despite wider footwear and reduced impact, repeatedly returns, or produces persistent tingling into the toes. People with diabetes, reduced sensation or poor circulation should have new skin damage or swelling assessed early because unnoticed pressure can harm the foot.

Ask whether the findings fit bursitis, nerve irritation, a joint problem or bone stress. Request guidance on toe-box width, pad placement and which activities are safe to continue. If an injection is being considered, ask how the target will be identified and which nearby structures need protection.