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Bursitis
from: Dr. Jeffrey A. Oster, Medical Director Of Myfootshop.com.Bursitis is an inflammatory condition that can occur at any joint. When bursitis effects the foot, the most common joints effected are those of the forefoot or ball of the foot. The most common site that bursitis occurs is beneath the second metatarsal head as shown in the picture on this page. The plantar (bottom) aspect of each of the metatarsal heads is marked and numbered. The blue area adjacent to the second metatarsal head is the most common area of the forefoot where we find bursitis occurring.
Treatment of bursitis
The first step in treating forefoot bursitis is to find ways to off load the forefoot. Off loading is a simple technique that can be achieved in many different ways. Pads and cushions are by for the most popular ways to off load the forefoot. A trip to any shoe repair shop will be a valuable lesson for anyone with forefoot capsulitis. The shoe repair shop can explain the size, placement and logic behind the use of a metatarsal pads. Shoes desgn can also be used to off load the forefoot. One simple example would be clogs. The rocker sole on clogs has been used for years to off load the forefoot. Orthotics are another method used to off load the forefoot.
Should the methods mentions for off loading fail to relieve the pain, an injection of cortisone can do wonders to treat bursitis. It's important to realize that bursitis is typically a mechanical problem caused by focal loading on one metatarsal head. Logic says that off loading is necessary. Cortisone approaches the problem from a little bit different direction. I often compare a shot of cortisone to throwing a wet blanket over the fire without actually knowing why the fire's there. But the bottom line is that cortisone often helps. In many instances, a shot of cortisone can make a problem of bursitis disappear indefinitely.
And lastly, surgical procedures may help in recalcitrant cases of bursitis. In particular, a metatarsal osteotomy can be used. An osteotomy is a surgical fracture in the metatarsal bone to raise the metatarsal head up and away from the ground thus reducing the forces that contribute to bursitis.
About the Author
Jeffrey A. Oster, DPM, C.Ped is a board certified foot and ankle surgeon. Dr. Oster is also board certified in pedorthics. Dr. Oster is medical director of Myfootshop.com and is in active practice in Granville, Ohio.
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