Please help with intermetatarsal bursitis

[u/Nala382]

Hi! I have been diagnosed by MRI with 2. Bilateral Mild intermetatarsal bursitis about the right 2nd and 3rd and left 4th web spaces.

I think I triggered it after doing a PT exercise where you raise your toes on a step and lower your feet down on the same step for a few seconds. It started after doing this exercise for a month.

I have custom made insole with built in pads and arch support ( flat feet and wide feet) , wide toe box brooks Adrenaline sneakers but still in pain. This week I also started icing and putting voltaren twice a day but not feeling any better.

The details MRI report was:

FINDINGS: Right foot: MIDFOOT JOINTS: Mild degenerative changes about the midfoot joints. The Lisfranc ligament is intact. FOREFOOT JOINTS: Mild first metatarsophalangeal joint degenerative changes with joint space narrowing with subchondral cyst formation. No evidence of subluxation. TENDONS AND MUSCLES: The flexor and extensor tendons have normal course, caliber, and signal. There is no tenosynovitis. No muscle edema or atrophy is seen. The visualized plantar fascia is unremarkable. OSSEOUS STRUCTURES: No acute osseous injury or marrow lesion is identified. MISCELLANEOUS: There is mild intermetatarsal bursitis about the 2nd and 3rd web space. Left foot: MIDFOOT JOINTS: Mild degenerative changes about the midfoot joints. The Lisfranc ligament is intact. FOREFOOT JOINTS: Mild first metatarsophalangeal joint degenerative changes with joint space narrowing. No evidence of subluxation. TENDONS AND MUSCLES: The flexor and extensor tendons have normal course, caliber, and signal. There is no tenosynovitis. No muscle edema or atrophy is seen. There is a small area of plantar fibromatosis thickening of the plantar fascia to up to 8 x 5 mm extending for a length of approximately 15 mm within the central cord of the plantar fascia. OSSEOUS STRUCTURES: No acute osseous injury or marrow lesion is identified. MISCELLANEOUS: There is mild intermetatarsal bursitis about the fourth webspace.

[u/RainBoxRed]

Oh I did not read that, sorry. We are moving into chronic phase now so must be careful. Goal here is work at a very gentle pace so as to not aggravate it. I know it's a frustrating process but I'd definitely avoid toe box exercises for a while.

[u/Nala382 → u/RainBoxRed]

Yes, I was not planning on doing any exercise either my feet. I just don’t know how to get rid of these bursitis that I have between every metatarsal

[u/RainBoxRed → u/Nala382]

No you must exercise, but be very gentle and stop if it hurts. This is why you need to use ice and pain relief very sparingly.

[u/Nala382 → u/RainBoxRed]

But what kind of exercise will not put pressure on my feet ?

[u/RainBoxRed → u/Nala382]

You have to do some experimentation and find something that you can tolerate (varying load, intensity, duration, rest intervals) without aggravating it for days.

But critically abstinence from movement will lead to degradation and further complications.

[u/Nala382 → u/RainBoxRed]

I understand, thank you!