What Is Foot bursitis?

What is foot bursitis | Sutherland Podiatry Centre

Today I want to talk to you about bursitis. In the cooler months people return to their shoes and boots and we will typically see an increase in footwear related conditions including bursitis. Foot bursitis is rarely discussed in comparison to muscle, tendon, and ligament ailments, but surprisingly is a very common cause of foot pain.

So what is a bursa?

A bursa is a small fluid-filled cushioning sac located near tendons, ligaments, skin, and muscles. The bursa works by protecting structures that would otherwise rub directly across the surface of a bone and cause damage or irritation. Still can’t quite picture it? Try to think of a bursa as a piece of glad wrap with a slimy egg white style of fluid in it.

Healthy normal bursae allow for a smooth, almost frictionless functional gliding surface making normal movement painless. When bursitis occurs, movement relying upon the inflamed bursa becomes difficult and can be very painful. Additionally, movement of tendons and muscles over the inflamed bursa aggravates its inflammation and perpetuating the problem.

The bursae (plural for bursa) are very important to prevent friction, absorb shock, and decrease the wear and tear between moving structures. There are multiple bursae located in the forefoot area. The metatarsal bursae are located on the bottom of the foot near the base of the toes. Metatarsal bursitis commonly affects the second metatarsal head (the toe next to the big toe) but can also affect the tiny bursae located between the metatarsal bones which are known as intermetatarsal bursae. If these bursae become inflamed or irritated this is called intermetatarsal bursitis.

What can cause bursitis?

Bursitis in the foot may occur in several ways. It may present after direct trauma to the foot falls, slips, auto accidents, and sport-related impacts. However, the cause of bursitis in the forefoot is predominantly due to irritation from repetitive use and overuse, such as during prolonged standing or running. Direct pressure applied to an area over a bursa, such as from wearing boots that are too tight, may also be a causative factor. Certain foot and gait abnormalities, such as an abnormal toe joint, over pronation, flat feet, bunions, or hammer toes, can place additional stress on the bursa and lead to bursitis.

Pronation of the foot can cause the metatarsal heads to rotate slightly and pinch the tissues and structures running between the metatarsal heads. This chronic pinching can create a bursa to protect the surrounding structures. By itself this is not a problem, however if the friction continues the bursa will enlarge and become more swollen and cause symptoms.

The type of shoes worn during high-impact running, walking, and jumping activities can play a role in foot bursitis since inappropriate footwear allows for an increase in the amount of shock the bursa must absorb. Obesity can also increase how much stress is placed on a bursa.

What are some of the symptoms I would have if I was suffering bursitis?

  • Localised swelling, pain, tenderness, warmth, and redness
  • Walking barefoot, wearing tight socks, wearing tight shoes, or any other action that increases pressure over the bursa may exacerbate pain
  • Walking, running, and jumping motions may be especially painful
  • Range of motion in the joint near the affected bursa may be limited

What can I do if I think I have bursitis?

Firstly you should try a few things yourself at home

  • Wear shoes which are nice and broad at the forefoot
  • Don’t lace the forefoot part of your shoe too tight
  • Make sure your feet are in supportive shoes that do not squeeze your forefoot
  • If possible, try to avoid shoes which taper towards a point

Bursae can also be treated with rest, ice, elevation. Since bursitis is caused by increased friction from surrounding structures, a compression would create more friction around the joint and is not a good idea.

If the above advice isn’t helping you manage the pain, the next step is to come and get it looked at by your podiatrist who will do a full assessment of your footwear and gait pattern. They may also want to check everything with an x-ray or ultrasound.

Their treatment may include

  • Additional footwear advice
  • Deflective padding in your shoes
  • Orthotics
  • Dry needling/acupuncture
  • Surgical referral

The earlier conservative treatment of foot bursitis takes place the better the outcome! If anything I have spoken about today is ringing a bell with you or someone you know, come in and have it checked out and we can go from there. Don’t forget to bring a pair of your joggers and/or work shoes.

Until next time,

31 Comments. Leave new

  • maureencrew12@gmail.com
    October 30, 2020 6:35 pm

    I have bursitis between my fourth and little toe I’ve had this for a year or more it’s unbearable in certain shoes
    Is there somewhere in Brisbane for it to be treated

    • Go see Dr Peereboom. He’s in the city. He’s fantastic.

    • I’ve also lived with this and had good help. But about shoes – the other thing that was relevant to me was to move out of very flexible soles (as many shoes are!) into shoes with decent stiffness in the mid-sole. Hard to find in women’s shoes (flexible mid-soles is the norm). Toe box vital, as Kym has written! But the sole also made a huge difference for me. Complete change in shoe type . . . . old favourites out the door. : ( But I haven’t had to get another injection in to the area since the change in footwear. : )

      • Hello, thank you for this advice. Could you give an example of a brand or the type of shoes you have found that have stiff mid-soles? I’ve had bursitis in my foot/toe for almost four years and have tried many things: orthotics, cortisone injections, acupuncture. I have found that birkenstock sandals are the only shoes I can wear with no pain but in the winter that doesn’t work. I’ve bought birkenstock insoles but somehow they don’t seem to hit the right point in my closed shoes and I still have pain when walking, although it’s bearable. Thank you for any help – I am getting desperate! Wondering about surgery and will continue on my quest to deal with this problem. I’m in France by the way…

        • Simone Christakakis
          January 31, 2021 3:52 pm

          Hi Jennifer I have exactly the same problem Bursitis in foot/toe for nearly 2 years now and can also only wear birkenstock sandals I ve had cold laser therapy up till now Definitely helped but only to a point Still can’t push off with second toe real well I had my first cortisone shot 3 days ago Sure hope that will help although bit sore today Did a cortisone shot help you at all? And how soon after injection did u feel relief if any? Sure would b nice to wear some different shoes again 1 day hey

          • Marie Sacksteder
            October 5, 2021 2:16 pm

            SAS Shoes and they’re made in the USA you can go on eBay brand new very inexpensive

        • Hello, try Frankie4, lace up sneakers. The sole is quite stiff and they have a wide toe box. They have really stopped the pain in the ball of my foot. Expensive but totally worth it.

      • Cheryl Hawkins
        April 2, 2023 9:24 am

        Was your injection uncomfortable

  • Thank you for your informative article it’s the best information I have read. I have suffered from extremely painful bursitis in my foot for over 2 years and after being diagnosed with plantar fasciitis, torn plantar plate and mortens neuroma along with bursitis. I have been in and out of moon boots with only a few months at a time of respite. I have had so many orthodics made up I now have a collection. The last podiatrist told me I was just genetically predisposed to injury and that I just didn’t fall into a typical textbook case although it’s only the one foot affected. I would be so grateful for any suggestions, I live in Brisbane.

  • Alegria shoes are fantastic, they are not cheap (look for them on sale online) but they have a flat solid sole and wide toe area, plus they come in the most amazing colours & patterns. I saw my podiatrist, she diagnosed bursitis under my foot and said my Alegria shoes were ideal (they also come in black styles for nurses). My podiatrist also recommended Birkenstocks and Duckfeet shoes.

    • I think I have this condition I wear safety shoes all day . I love to wear converse shoes . I also have a bunion on my same foot I’m having issues with not sure if this what causing my pain .

  • I have had a bursitis between the 4th and 5th metatarsal for the last 5 years – it has been pretty painful and it has restricted some activities – for example I can no longer run. I have been receiving cortisone injections – it provides some relief, but it always gets worse with time and it is never completely fine. Lately, I have noticed some potential muscle loss in the area – like I have a long indentation on the top of my foot in the problem area. Anyone has had something like that happening? I am thinking about getting a surgery to have the bursa removed, but I am worried about possible permanent mobility limitations! In terms of comfortable shoes – I found Kuru shoes work really well!

    • Lisa Clarence
      March 31, 2021 11:30 pm

      I have an issue with my 2nd and 3rd toe spasming and after having tests found I have bursitis between those toes on both feet. My question is could the bursitis be causing my toes to spasm?

      • Sangita Kachhela
        November 19, 2022 6:24 am

        Hi there, just read your msg and wanted to ask you what your pain is like when your toes spasm. I have bursitis too inbetween my 3-4 ties left foot and i used the phrase spasm because my ties looked like they would stick to one another and I would cramp so bad in that area when I first started to experience pain in that area. Thank you

    • The indentation is likely atrophy from your steroid injections. It Chili’s correct if you stop injecting!

    • The indentation is likely atrophy from your steroid injections. It Usually corrects if you stop injecting!

  • I’ve had bursitis in my left foot for five years. Cortisone didn’t work and neither did acupuncture. It’s something I live with every day and it’s altered a lot of things I do and wear. I hate it and wish there was a better treatment for it.

  • I have bursitis between all of my toes (both feet) for over 1,5 year along with artritis in my big toe.. I really tried everything like; orthopedic sole, injections, medicine (anti inflammation), acupuncture, cupping, massage, every foot cream on the market. Is there anything else I can try?? I feel so limited in my life and don’t have any hope that it will go away soon

  • I have just been diagnosed with bursitis in the balls of my feet Has anyone tried the patches ?

  • Hi , I think I might have Bursitis. I am a UPS driver and use my right foot a lot on the brake pedal. My right toe is swollen and I have trouble bending it.
    I usually don’t feel my toe during the day walking a lot. It does hurt when i touch it and try to bend it down. Anything I can do ? Thanks

  • Anita Fisher
    July 5, 2021 4:27 am

    I have had x 2 Morton’s Neuroma’s & had to have surgical intervention. Now have Bursitis in between 3rd & 4th Metatarsals. Didn’t respond to steroid injection & now awaiting surgery to remove the Bursa. Shoe wise I find FlipFlop the best.

    • Anita-do you mean you find “Fit Flop” shoes the best, of Flip Flop style sandals? Curious because I’m looking for good shoes to help alleviate the pain.

  • SmokeyToeJoe
    July 13, 2021 2:06 pm

    Should be called rock climbers toe. Happens to so many climbers from wearing tiny shoes. I have one on the knuckle closest to the nail on my 2nd toe. Out of curiosity I put a pin into it and weird clear (I guess colagen) came out. Not sure whether to leave it or get it looked at.

  • Hi I have a bump on my outside foot straight down from my big toe. It’s where most people get bunions but X-ray didn’t show a bunion. One podiatrist said it’s a keratosis but it’s red and painful over and under it. Another recommended a MRI to see if it’s bursitis. Can you get it in that location?

  • I had bursitis, in front of both feet back in 2011, had to use a walker frame for about 3 years. Its come back again now in 2022, all my orthotics are worn out, the last new ones I couldn’t wear at all, or the shoes they mad for me. Is there anyone in Adelaide I could see please.

  • Patti congdon
    January 4, 2023 1:36 am

    Mine started in left foot around heel right when that got better my right foot on side hurts like the left did is this normal

  • I have extremely painful stinging pain which develops in the ends of my second and third toes often . It feel’s just like a needle being inserted into the toes. A foot scan showed toe bursitis. I don’t have Morton’s neuroma. The pain develops when I’m standing for a few hours when working in a shop. Does anyone else have these particular symptoms?

  • I’ve just been diagnosed with bursitis in my second and third toes on my left foot and am going for a cortisone injection asap. I also have a bunion which has increased in size and causes pain. I work at both of Brisbane’s airports and can walk up to 12km in a shift. We are supposed to wear heels but as I can’t, I wear leather look slip on sketchers as heels kill my feet and back. I left my disability care job because of bursitis in my left hip and other back problems. The cortisone didn’t help my hip. How ironic that another career is causing bursitis. I also have fibromyalgia which causes a whole other world of pain. I need to find a comfy pair of shoes suitable for my work environment. I’m not really in the position to buy shoes that I can’t wear and will sit in the cupboard gathering dust. I purchased Hush Puppies and they caused me a lot of pain and swelling. I’ve spent around $350 on shoes in 5 months :).

  • Cheryl Hawkins
    April 2, 2023 9:21 am

    I have bursitis in my second and third toes and the ball of my foot is so sore iv had it for a year and a half ,I also have a bouion too on my right foot I have also been told that’s what causes img the bursitis. They what me to gave a injection but this won’t cure it I’m trying to avoid bunion as I have had one done five years ago but if that the only option left can some one help I live in Mornington Victoria

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