The metatarsals are the long bones in the foot. The image below shows the metatarsals and most would consider the 5th metatarsal to be the "last one."
It's difficult to say what is causing your pain. Isolated problems at the 5th metatarsal are rare. The 2nd, 3rd and 4th metatarsals are common areas for stress fractures.
Stress fractures (incomplete break in the bone) generally appear as acute swelling and pain in the midfoot area, with no history of trauma. Pain is worse with standing and walking and particularly with pressure on the ball of the foot or going up and down stairs. The pain is generally relieved by rest. Many stress fractures do not show up on X-ray until 4 weeks after the pain started. A stress fracture at the 4th metatarsal could cause pain and swelling toward the outside of the midfoot area. In the X-ray below, the arrow points to evidence of healing at the base of the 3rd metatarsal from a stress fracture.
There can be pain at the 5th metatarsal phalangeal joint. This can occur from an injury or arthritis, but is commonly associated with a tailor's bunion/bunionette. A
bunionette is the result of the movement of the metatarsal bone over time due to faulty foot mechanics. There may be swelling at the joint or a bursa may develop. The development of pain and irritation is gradual and the pain is generally deep and achy, worse with shoes and walking and dull at rest.
Further back on the foot, at the base of the 5th metatarsal is a tendon insertion. Insertional
peroneal tendonitis can cause pain and swelling at the base of the 5th metatarsal. The development of the pain is gradual, and the pain is commonly worse when getting up out of bed or walking after periods of rest. There is also a stiffness associated with the pain and the pain may travel up the outside of the leg. In the image below, the peroneus brevis tendon is shown at it's insertion on the base of the 5th metatarsal.
My foots been hurting for 3 weeks
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