Hi Dr. Blake!
I'm so glad I stumbled upon your blog today and that you're taking
questions! I have what's been "officially diagnosed" as bursitis on
the top of my left foot at the second metatarsal head and am hoping
you can shed some light on treatment for this aside from
ultrasound-guided cortisone injection.
In July 2014 I suddenly developed pain btw the 2nd & 3rd metatarsals
on my left foot near the toes. I don't recall injuring my foot but I
had been wearing some "barefoot" sandals a lot and having some issues
with my foot sliding around in them, which caused a lot "gripping" of
the toes. (I had already spent many years "barefooting" without issue
in Vibram Five Fingers at this point, but had moved from TX to PA
about 8 months prior and spent a lot of time in slippers/shoes because
of the cold, so simply wearing a minimalist shoe was not the issue.)
My chiropractor did regular ART on my foot over several months but
there was no improvement, so he tried Graston. A few weeks after he
started trying Graston on my foot, in Oct 2014, the pain moved from
the inter-metatarsal area to the joint at the head of the 2nd
metatarsal. The pain became more severe, and by Thanksgiving 2014 I
was unable to walk.
X-rays were negative but MRI in early December 2014 showed a stress
reaction at the head of the second metatarsal as well as inflamed
bursa. I was put into a fracture boot and spent 4 months in it
full-time. I spent another 2.5 months transitioning out of the
fracture boot into running shoes. By June 2015 I was full-time in
running shoes, but still in pain.
MRI in June 2015 showed that the bone was 98% healed but there is
still bursitis at the head of the second metatarsal. Orthopedist
recommended ultrasound-guided cortisone injection to address it, which
I haven't done yet.
At the beginning of Sept 2015 I began to see a podiatrist for therapy
twice per week. He places the 2nd & 3rd toes in traction for 10 min,
followed by 10-15 min of electrical stimulation, and then tapes the
foot to support & relieve pain. The tape is kept on for a couple days
each time. I've been for this treatment 6 times over 4 weeks and have
experienced some improvement, but he tapes my foot differently every
time and the more recent times it hasn't been as helpful or has even
increased my pain.
His theory is that my issues stem from my feet being structurally
unsound and that if he figures out how to tape my foot to relieve pain
then I can get orthotics that will essentially do what the tape does
and then I'll be fine.
Side note about my feet: they are very, very flat. I had severe
bunions (& bunionettes) from childhood, which were surgically removed
16 years ago at age 21. Both my 1st & 5th metatarsals were broken in
both feet. The bunionectomies were Austin and the podiatrist says they
effectively shortened my 1st metatarsal, making the 2nd one too long
and setting me up for this bursitis issue. It's also worth noting that
on my other foot (the right foot) the bunion has been slowly starting
to come back over the last 3 years, and my big toe is drifting towards
the other toes. It bothers me because I have tightness in the arch and
between my 1st & 2nd toes, but it's not painful.
So what do you think? Orthotics? Cortisone shot? Anything else I can
do/consider? I'm very frustrated because I haven't been able to walk
properly in over a year and am experiencing all kinds of other
hip/back issues now as a result. I'm only 37 and really want to be
Thank you for any insights or recommendations you can share!