An Overview of Intermetatarsal Bursitis

The metatarsal bursa is located at the base of the toes on the bottom of the foot. This bursa can be irritated when one metatarsal bone takes more load than the others, often through excessive repetitive movement, wearing high heeled shoes or wearing shoes that don't fit properly. When this happens, the soft tissue between the bone and the skin becomes compressed and inflammation in the bursa can begin. Walking barefoot on a hardwood or tiled floor without cushioning will increase pain noticeably due to the direct pressure on the metatarsal bursa.

What Causes Intermetatarsal Bursitis?

Foot pain can often be quite complicated when trying discover what is really causing you to limp or even lose time at work. The foot is a very complex system of bones, tendons, ligaments, bursa and sesamoid bones - once you consider the fact that the feet support an extremely high load, often for very long periods of time, you can understand why it is important for them to function correctly. There are many causes of intermetatarsal bursitis - a few of the more common causes are outlined below:

A sudden impact to the area of the foot such as stepping on the ball of the foot incorrectly, or unknowingly stepping on an item (ie. a piece of Lego) that causes a lot of pressure on one area of the toe base.

A fractured bone that causes inflammation in the area including the bursa sac itself.

An injury to soft tissue surrounding the bursa sac can lead to a buildup of scar tissue. This scar tissue thickens the lining of the bursa, making it difficult to do it's job of lubricating the joint and allowing the tissues to glide smoothly. This causes added friction and leads to high risk of bursitis.

Poorly constructed or worn out footwear that does not have enough support for the ball of the foot adds stress and weakens local soft tissue. This soft tissue tightens around the bursa, causing irritation.

Poor foot structure - either genetic, from osteoarthritis, gout, or from a previous injury/accident will affect the way you walk. This misalignment of bones or weakened soft tissue can put excess stress on the bursa and potentially lead to bursitis.

Intermetatarsal bursitis can stem from a sports related injury when running shoes that are too tight or in sports that cause repetitive stress to the ball of the foot such as rugby, football and running sports in general. Playing running sports on hard surfaces causes excess stress on the metatarsals and as such, can increase the risk of incurring bursitis in the metatarsals.

Intermetatarsal bursitis is typically more noticeable in the winter months when wearing tighter shoes/boots. The added compression of this footwear can increase the risks of contracting this condition.

The condition most often affects women who frequently wear pointed, high-heeled, close-toed or poorly designed footwear. The pain increases with walking, weight-bearing movement, and tight-fitting shoes.

Do You Really Have Intermetatarsal Bursitis?

Visiting your doctor when you have foot, ankle or heel pain is always recommended, as there are many possible issues that can happen within the foot. Our feet are some of the most complicated joints in our bodies with 26 bones, 33 joints and more than 100 tendons, muscles and ligaments. Pain in the ball of the foot can be caused by many injuries and sometimes, one set of symptoms can result in multiple diagnoses.

Some conditions that can show similar symptoms to intermetatarsal bursitis:

• Stress Fracture - a break in the one of the bones in the toe or ball of the foot. Increased loads to the area causes the bones to weaken and micro fractures without rest the bones will completely fracture.
• Plantar Plate Tear/Strain - This condition usually causes sharp pain right under the toe, and your toe may be out of alignment with your other toes. The ligament that holds toe bones in place has become injured from toes being pushed in an upward motion or from activity such as standing on your toes.
• Morton's neuroma - If you have Morton's Neuroma, you are experiencing a thickening of soft tissue that surrounds the digital nerve leading to the toes and is generally caused by irritation, trauma or excessive pressure. Moreover, Morton's neuroma most frequently develops between the third and fourth toes. This condition usually causes burning pain in the ball of the foot that may radiate into the toes. The pain generally intensifies with activity or wearing shoes. You may sometimes feel that you are "walking on a marble," and you have persistent pain in the ball of your foot. You may also have numbness in the toes. Morton's Neuroma is sometimes misdiagnosed as a plantar plate tear as the two conditions have similar symptoms.
• Metatarsalgia - This condition can also cause pain in the ball of your foot - the area between your arch and the toes. Metatarsalgia is a common overuse injury, persistent stress can lead to chronic irritation and inflammation of the bone covering and surrounding tissues, such as ligaments and tendons. Metatarsalgia is generally not considered a medically serious condition though it certainly has the ability to keep you off your feet until it goes away.
• Sesamoiditis - The big toe has two very tiny bones embedded in tendon tissue in the ball of the foot. Any type of injury to the tendon tissue can cause irritation in and around the sesamoid bones. This condition can also cause pain in the ball of your foot, and into the big toe. Sesamoiditis is a common overuse injury, persistent stress can lead to chronic irritation.
• Plantar Fasciitis - Pain associated with plantar fasciitis normally starts as a dull ache and then progresses to a sharp, knife-like pain or constant throbbing feeling that is worse when you put weight on your foot. The most tender areas tend to be in the center of your heel and along the inside and bottom of your foot towards your toes, where your heel and arch meet.
• Turf toe - This can happen when the big toe joint is pushed beyond its' normal range (backwards or downwards). A 'pop' is felt at the moment the injury happens followed by sharp immediate pain. Symptoms include swelling in the foot, the entire big toe joint is affected and limits the range of motion in the toe.
• Predislocation syndrome, crossover toe deformity and floating toe syndrome are terms related to a plantar plate tear or sprain.

Conservative Home Remedies for Intermetatarsal Bursitis

In the following section, we outline effective conservative treatments for Intermetatarsal Bursitis

Many cases of bursitis in the foot will heal by elimination of poor fitting footwear and the incorporation of simple home conservative treatments. Surgery is often not needed for dealing with bursitis and is typically considered as a last option resort.

It's generally understood by doctors and surgeons that surgery will introduce more scar tissue into tendons and ligaments (soft tissue) in your foot. This added scar tissue will be problematic, requiring PT and conservative treatment options post-surgery. When it comes to bursitis there's only a few surgical options for treatment - removal of the bursa sac, scraping of the bone(s) to allow more room for the new bursa to grow back. This is why surgery is only performed as a last resort for chronic bursitis that has not responded to 2 to 4 months of conservative treatment methods.

Conservative treatment methods recommended include:

• Rest - This is important for initial recovery; rest and elevation will help reduce pain, swelling and inflammation in the early stages of injury. This can be difficult when you have to carry on with daily activities, but resting and elevating your foot whenever you can is recommended. During your recovery you will probably have to modify or avoid the activities that put stress on your calf, lower leg & foot until your pain and inflammation settles. However, too much rest can also be harmful to such injuries because knee, ankle and foot immobility can actually cause stiffening in the joints. This is why rest should be used when reducing initial pain and swelling, but should not be considered for more long-term conservative treatment.
• Avoid Activities that Caused Your Bursitis - While resting your foot it's also important to avoid all activities that may have caused or exacerbated the problem (especially any strenuous or repetitive movement). Continuing on with such activities will likely increase the severity of your injury (ie. wearing high heels or poor fitting footwear), turning a mild to moderate case of tissue damage into a downward spiral of worsening damage that may eventually severely impact your life. Also, trying to 'work around' your injury will eventually give rise to over-compensation injuries in other areas of your body (like your opposite foot, or hip & knee pain due to your limping gait).
• Use a Cold Compress or Ice Pack - Cold is very effective at reducing pain and inflammation - use at the onset of the injury and during flareups. Immediate pain relief and reduced inflammation can also relieve some of the pressure that's being placed on your bursa although cold temporarily shortens connective tissue (tendons, muscle, fascia) causing more friction on the bursa sac. Generally, use cold when there is swelling but stop once swelling is down. In cases of chronic (long term) bursitis, there is typically little to no inflammation.
• Use a TShellz^® Circulatory Boost Wrap - Once swelling has been reduced, you can use your own blood flow to maximize your rehabilitation. Knowing the body uses blood flow to heal soft tissue, this wrap is intended to introduce heat and an increase in blood flow to the application area; this in turn, will assist the body in its own repair process, helping decrease recovery time while reducing re-injury risk. Promoting blood flow and heat to the area will help to minimize the growth of scar tissue, increase tissue flexibility and help reduce onset of atrophy. This is why we recommend a TShellz Wrap treatment before undergoing activity - an increase in flexibility should help reduce risk of further injury while also assisting in the battle against atrophy (what we are saying is that you want to keep your joint flexible so pressure on the bursa is minimized and secondary injury risk will be reduced).
• Use a Support Wrap or Brace (depending on the area). To increase comfort and prevent further damage you may want to use a support sleeve or brace to help support the area, reduce risk of further injury and reduce stress on the injured tissue. They can be used until your injury is gone or during active sports for additional stability. Note that these should not be worn at all times as they can limit muscle development, cut off circulation and impede healing of muscle tissue.
• For reducing discomfort while resting, (or to get some sleep) consider a High Quality Knee Pillow for comfort while sleeping or raising the foot while sitting
• Rehabilitative Stretching under supervision of a PT or doctor. The intent of this is to provide you with increased range of motion, pain relief and strengthening of the surrounding tissue of the joint. Doctors or surgeons typically won't perform a surgery until they feel that their patient has put effort into treating their injury with conservative treatment methods. This may include up to 4 to 6 months of visits to a PT clinic. If you haven't experienced any improvement in your condition during that time then surgery may be considered.
• Stretching - Stretching your foot in PT and at home will help you to regain your range of motion much faster than not stretching at all. Stretching in many ways is key maintaining good Range of Motion (ROM) in your joint, and stretching can be made much easier with use of a TShellz Wrap^® before to warm up soft tissue, and a Cold Compress or Ice Pack treatment after to prevent any return of swelling and inflammation.

Home Treatment Stage 1: Reduce Pain & Swelling with a Cold Compress or Ice Pack

The 1st step for conservative treatment of your knee bursitis when treating conservatively or even after surgery is to rest and reduce swelling to "open up" the area for more blood flow. Anyone in the health-care business knows that your blood supplies the oxygen and much needed nutrients required for your body to heal naturally from damage (including after surgery). This is why doctors and surgeons recommend cold compression within the first 72 hours of any tissue injury or following surgery.

Cold compression is recommended to reduce pain, swelling and tissue damage. Many doctors, surgeons and physical therapists consider cold compression to be the gold standard for treatment of inflammation and pain. On-going cold compression treatments can reduce, or even eliminate, the need for NSAIDs or other medications that can be harmful to your body.

Cold compression is known and trusted by most medical professionals. This is why for years doctors, trainers and other medical professionals have recommended RICE (Rest, Ice, Compression, Elevation) to treat the pain and swelling of fresh injuries, chronic pain, after any re-injury, and especially after surgery.

When to use a Cold Compress or Ice Pack:

• 24 to 72 hours after your initial injury or when you first notice pain and swelling to stop further damage to tissue, relieve pain, and decrease swelling.
• After exercise, workouts or activity of any kind to prevent re-injury.
• Before and after surgery during rehabilitation to control pain and swelling for both pre-surgery and post-surgery.
• Anytime you feel that soft tissue (muscles in particular) has been over-extended, over-worked, twisted, strained or sprained causing pain and swelling.
• Anytime you have swelling, sharp throbbing pain or inflammation.
• Any other situation where you need to draw the pain and inflammation out of the area.

Home Treatment Stage 3: In Between Treatments With A TShellz Wrap^®, Apply Our New Fast Acting Pain Relief Cream Called ARNICA INFUSION

Dealing with aches and pains affecting the foot, ankle, leg, knee, hamstring, hip, back, arm, shoulder, elbow, wrist, or hand? If so, then applying the Arnica Infusion to any of these targeted areas will bring about fast relief from the pain and sore tissues. Simply apply a small amount of cream to the body and moments later, you will experience a soothing and comforting sensation over the area.

Arnica Infusion is specially designed to relieve pain due to sore muscles and joints associated with arthritis, backaches, sprains, strains, and bruises. No matter if you are dealing with an acute injury, chronic pain, or a general "flare-up" - you will experience fast relief from pain and inflammation.

A lot of our customers asked us for pain cream, so we focused our resources and came up with what we believe to be the most effective, fast acting, topical pain relief cream you can buy without a prescription.

You are likely familiar with some of the standard topical creams on the market as most of our customers use them. They are mass marketed and even found in most department stores... Well, we are here to say that Arnica Infusion goes many steps beyond what they offer.

Made in the USA at an FDA registered manufacturing facility, you can be assured that Arnica Infusion is both safe and effective. We only source top grade ingredients while implementing strict quality control checks during every step of the production process. Expect the same high quality that MendMeShop customers have been accustomed to since we started the company in 2005.

The "Cool Blue" formula is the perfect balance between the smooth application of a cream and the effective absorbing factor of a gel. It is not too thick and not too thin - just the right texture. Best of all, it feels very nice on the skin!

Each application of Arnica Infusion feels so comforting and soothing, we are certain it will become an item you will not want to live without.

Arnica Infusion Ingredients

The Arnica Infusion formula is based on a combination of scientific research and the use of high quality ingredients. The properties within the formula were chosen for their pain relief, anti-inflammatory, and soothing qualities.

The acting ingredients within the formula include ones many of us are familiar with; along with ones that have not received a lot of publicity (only in research circles). Extensive testing resulted in a blending of ingredients that provides the most synergistic of benefits.

The notable ingredients in the Arnica Infusion formula include:

• Arnica - powerful anti-inflammatory, speeds recovery, enhances circulation
• Menthol - provides deep penetrating pain relief with a nice cooling sensation
• Vitamin B6 - promotes normal nerve function
• MSM - supports healthy connective tissues, anti-inflammatory
• Ilex Leaf Extract - increases circulation, skin conditioner
• Vitamin E - anti-inflammatory, enhances circulation, hydrates the skin
• Aloe - anti-inflammatory properties, soothes the skin
• Tea Tree - enhances penetration of ingredients

Extensive quality control procedures during the manufacturing process ensure the ingredients and final product are both safe and effective. We would not stake our reputation on anything but the best.