Metatarsalgia

Diagnosis/Definition

Idiopathic pain on the plantar aspect of the ball of the foot.

Initial Diagnosis and Management

• History and physical examination.

• Appropriate weight-bearing foot x-rays and laboratory studies (Rheumatology panel evaluation if inflammatory, bilateral, and accompanied by other joint symptoms).

Ongoing Management and Objectives

Initial primary care treatment should consist of a three-month trial of the following: NSAIDs, over-the-counter soft insoles (i.e., Spenco), soft supporting shoes with a wide toe box (running or walking type), decreased activity (rest).

Indications for Specialty Care Referral

Patients without improvement of symptoms after the three-month trial period can be referred to the Podiatry Clinic.

Criteria for Return to Primary Care

Patients will be returned to primary care for chronic management after biomechanical/orthotic management (non-surgical candidates) or surgical treatment is complete.