What should you know about submetatarsal bursitis?

Small bursae help reduce friction where the metatarsal bones meet the tissues under the forefoot. Repeated walking or running, tight shoes, a high heel, altered foot mechanics, or a change in activity can increase pressure there. Pain may feel like a bruise or a small pebble beneath the ball of the foot and can worsen when standing, pushing off, or walking barefoot. Some people notice local swelling or warmth.

Forefoot pain also occurs with calluses, nerve irritation, stress injury, or joint problems. A clinician can examine footwear, walking pattern, sensation, and the tender area to narrow the cause.

Switch to shoes with a roomy toe box, a low stable heel, and cushioning under the forefoot. Reduce high-impact activity and avoid walking barefoot on hard floors while pain is active. A metatarsal pad may help when positioned behind, rather than directly under, the sore spot; a podiatry or physiotherapy assessment can guide placement. Medication, aspiration, or a cortisone injection may be discussed when symptoms do not settle, but treatment should match the diagnosis.

Arrange prompt care for a hot, red, rapidly swollen foot, fever, drainage, inability to bear weight, or pain after a significant injury. Seek assessment for numbness, colour change, or a wound that is slow to heal. Make an appointment when pain persists despite changing shoes and activity, keeps returning, or limits normal walking.

Ask: Is the pain coming from a bursa, bone, joint, or nerve? Would an insert or metatarsal pad redistribute pressure? Do I need imaging? Which activities can I continue safely, and what should prompt a review?