Bursitis/Interdigital Nerve Pain in the Forefoot

Bursa are fluid filled sac’s that separate, cushion, and lubricate in order to reduce friction between surfaces that move in opposite directions. Bursitis is inflammation of these bursa’s that over lie the joints in the feet, more commonly in the forefoot.

Interdigital nerve pain can often be referred to as a neuroma or more commonly Morton’s neuroma.

This is inflammation of the nerve or a fibrous build-up of tissue around the nerve.

Causes

Narrow shoes/high heeled shoes, standing for long periods, poor foot biomechanics (excessive pronation- foot rolling inwards) and stiff high arched feet.

 

Signs and Symptoms

  • Pain in the forefoot (usually under the foot)
  • Stiffness of the toes
  • Numbness in the toes, feeling of an electrical jolt like sensation.
  • Sensation feels like patient is walking on a marble
  • More commonly in the 3rd metatarsal space

 

Treatment

  • Ice
  • Corrective footwear
  • Orthotics with specific paddings to off load bursa’s or neuroma’s
  • In more chronic cases ultrasound guided steroid injections may be used to resolve pain and active inflammation.
  • Surgery can be an option if conservative treatment fails but it is rarely needed.

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