Bursitis in the foot might not be as often discussed as muscle, tendon, and ligament ailments, but bursitis is a actually a common cause of foot discomfort and pain. The average human body has about 160 bursae. Most of these are located near the major joints in the body, especially joints that perform frequent repetitive motions.

Foot Anatomy As It Relates To Bursitis

A bursa is a fluid-filled cushioning sac. They are located near tendons, ligaments, skin, and muscles that would otherwise rub directly across the surface of a bone. The bursae (plural for bursa) are very important to prevent friction, absorb shock, and decrease the wear and tear between moving structures. Think of a bursa as a piece of bubble wrap that secretes a slimy substance similar to the consistency of an egg white. Aside from the usual number of bursae found in the human body, additional bursae may develop whenever they’re needed. In other words, if an area in the foot is subjected to a great deal of stress that causes additional friction between soft tissue and bone, then additional bursa may form.

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 most often affects the second metatarsal head (the toe next to the big toe). The metatarsophalangeal bursa is located near the base of the big toe on the inner aspect of the foot. There are also many tiny bursae that are located between the metatarsal bones in the intermetatarsal spaces, thus the term intermetatarsal bursitis is used to describe this type of bursitis.

Foot bursitis is a term used to describe an inflamed bursa in the foot. As mentioned above, inflammation of a bursa in the heel is usually termed heel bursitis.

What Causes Foot Bursitis?

Bursitis in the foot may occur after direct trauma to the foot – falls, slips, auto accidents, and sport-related impacts. However, the cause of bursitis in the forefoot is most often due to irritation to the bursa sac from repetitive use and overuse, such as during prolonged standing or frequent participation in running activities. Direct pressure applied to an area over a bursa, such as from wearing shoes that are too tight, may also be a causative factor. Certain foot and gait abnormalities, such as an abnormal toe joint, overpronation, flat feet, bunions, or hammer toes, can place additional stress on the bursa and lead to bursitis. The type of shoes worn during high-impact running, walking, and jumping activities can play a role in foot bursitis since inappropriate shoes increase the amount of shock the bursa must absorb. Obesity can also increase how much stress is placed on a bursa.

biomechanical contributing factors explained

Pronation of the foot can cause the metatarsal heads to rotate slightly and pinch the tissues running between the metatarsal heads. This chronic pinching can create a bursa. As it enlarges it than becomes more swollen and increasingly troublesome causing  symptoms.

What Are The Symptoms Of Foot 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