The first metatarsal and big toe normally accept load during push-off. If the first ray becomes functionally shortened, elevated, stiff or painful, pressure can transfer laterally. Pre-existing lesser-toe instability can also become more apparent after correction.
Assessment may include footwear, callus pattern, joint examination, gait, weight-bearing imaging and sometimes ultrasound. Treatment ranges from rehabilitation and footwear modification to orthoses, injections or corrective surgery depending on the cause.
Restore first-ray loading gradually during rehabilitation.
Avoid narrow shoes and rapidly increasing walking volume.
Investigate persistent focal plantar pain rather than assuming it is routine swelling.
Assess associated hammertoe or plantar-plate pathology when present.
Does pain under the second metatarsal mean the bunion operation failed?
Not necessarily. Temporary gait compensation is common, but persistent focal pain needs assessment for mechanical transfer or pre-existing lesser-ray disease.