Bumps on the Fourth Metatarsal: Bursitis or Corn? - Orthopedics

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When it comes to understanding the bumps on the fourth metatarsal, it’s essential to differentiate between bursitis and a corn, as both conditions can present with similar symptoms but have different underlying causes and treatment approaches.

Bursitis is an inflammation of the bursa, a small fluid-filled sac that acts as a cushion between bones and soft tissues. In the foot, bursitis can occur due to repetitive stress or pressure on the metatarsal bones, often exacerbated by activities such as running or standing for long periods. The inflammation can lead to swelling and the formation of a bump over the affected area. Typically, bursitis is associated with tenderness, pain, and sometimes warmth in the area, especially when pressure is applied. However, in your case, you mentioned that the bump is not painful upon pressing, which may suggest that it is not classic bursitis.

On the other hand, corns (or calluses) are thickened areas of skin that develop in response to friction or pressure. They often form on the toes or the soles of the feet, particularly over bony prominences like the metatarsals. Corns can be painful, especially when walking or wearing tight shoes, but they can also be asymptomatic in some cases. The fact that you experience slight discomfort after prolonged walking could indicate that the bump is indeed a corn, particularly if it feels firm and has a central core.

Given that you have a history of bursitis in your wrist, it’s understandable to be concerned about a similar condition developing in your foot. However, the absence of pain upon pressure and the specific location of the bump suggest that it may be more related to a corn or callus formation rather than bursitis. The elevated inflammatory markers in your blood could indicate a systemic inflammatory response, but they do not definitively point to bursitis in the absence of other symptoms.

What to Do Next:
1. Observation: Monitor the bump for any changes in size, color, or pain. If it becomes painful or shows signs of infection (redness, warmth, swelling), seek medical attention.


2. Footwear: Ensure that you are wearing well-fitting shoes that provide adequate support and cushioning. Avoid tight shoes that may exacerbate friction on the fourth metatarsal.

3. Foot Care: Consider using protective pads or cushions to relieve pressure on the area. Regularly exfoliating the skin on your feet can also help manage corns and calluses.

4. Consultation: If the bump persists or worsens, it would be wise to consult with a healthcare professional, such as a podiatrist. They can perform a physical examination and may recommend imaging studies if necessary to rule out other conditions.

5. Treatment Options: If it is determined to be a corn, treatments may include debridement (removal of the thickened skin), orthotic devices to redistribute pressure, or topical treatments to soften the corn. If bursitis is confirmed, treatment may involve rest, ice, anti-inflammatory medications, or corticosteroid injections.

In conclusion, while both bursitis and corns can present as bumps on the foot, the characteristics of your bump, along with your symptomatology, suggest it may be more consistent with a corn. However, a thorough evaluation by a healthcare professional is essential for an accurate diagnosis and appropriate management.