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Forefoot Bursitis
Forefoot bursitis
Forefoot bursitis is a condition where little sacks of fluid  (bursas) which are designed to help cushion and protect structures become enlarged due to irritation.
The increase in size of the bursa can cause pain as they often get squished in their position- leading to pain in the forefoot area. The bursas also can start impinging on nerves that they are designed to help protect.
When the nerves become impinged neurological symptoms is common. This includes numbness, burning and tingling along the path of the nerve going into the toes. As the nerve bifurcates (splits into two nerves) and serves half of two different toes- symptoms will often be found in both toes.
 
The cause of forefoot bursitis can be multifactorial. Excessive forefoot pressure from wearing heels, tight shoes, hypermobility through the joints of the foot and tight plantar fascia & calf muscles.
 
Treatment- Like plantar fasciitis you need to address the causative factors. Buying shoes that have enough space in the forefoot is the best first step.
Heating, massaging and stretching the tight muscles also help, the tighter the muscles are in the foot the closer is brings the bones together which can irritate the bursas. If the calf muscles are tight it causes an excessive pressure on the forefoot so ensuring these muscles are happy also help.
 
The use of foot orthotics is also a simple treatment option that can help. By spreading the pressure out over the whole foot instead of creating a large amount of pressure in the forefoot is also beneficial. The orthotic will also help improve the space the space between the bones reducing the bursas from being irritated.
 
Further treatment like the use of ant-inflammatory can help- oral and topical are a very good start and the use of a cortisone injection can also help. 
 
Surgery is also an option where the calf muscles are lengthened to reduce the pressure in the forefoot. (Stretching is a much better start)

 
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