What should you know about intermetatarsal bursitis that won't heal?

An intermetatarsal bursa lies in the forefoot between metatarsal bones. Repeated squeezing from narrow shoes, high-impact activity or altered foot mechanics can keep the area irritated. Pain may feel burning, aching or sharp and can worsen with walking or toe pressure. A similar pattern can come from a nerve problem, stress injury, joint inflammation or another forefoot condition, so persistent symptoms should not be assumed to be bursitis without review.

Swelling, tenderness and changes in walking can shift pressure to nearby areas. A clinician may examine the spaces between the toes, assess footwear and movement, and decide whether imaging or another test is useful.

Choose shoes with a wide toe box and a stable, comfortable sole; avoid footwear that compresses the forefoot. Temporarily reduce activities that reproduce the pain, then return gradually as symptoms allow. Do not place repeated direct pressure on the tender space. A clinician may suggest padding, physiotherapy, an anti-inflammatory medicine or another targeted treatment after checking your medical history.

If symptoms continue despite these changes, arrange a reassessment rather than repeatedly increasing medication or activity. A cortisone injection may be considered in selected cases, while aspiration is reserved for situations where removing or testing fluid is clinically useful.

Seek prompt care for a red, hot, rapidly enlarging swelling, fever, drainage, an open wound or severe pain that prevents walking. Arrange an assessment soon if numbness is spreading, the foot changes colour, symptoms follow an injury or the pain remains despite a sensible period of pressure reduction.

Ask whether the symptoms fit an inflamed bursa or another forefoot problem, whether footwear or foot mechanics are contributing, and which treatment should be tried next. Ask what improvement to expect, when to review it, and whether an injection or aspiration has a clear purpose in your case.