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Treatments and drugs
By Mayo Clinic staffConservative measures usually relieve the pain of metatarsalgia.
- Rest. Protect your foot from further injury by not stressing it. You may need to avoid your favorite sport for a while, but you can stay fit with low-impact exercises, such as swimming or cycling. Continue with stretching and lower body strength training as your pain permits.
- Ice the affected area. Apply ice packs to the affected area for about 20 minutes at a time, several times a day. To protect your skin, wrap the ice packs in a thin towel.
- Take an over-the-counter pain reliever. Try ibuprofen (Advil, Motrin, others), naproxen (Aleve, others) or aspirin to reduce pain and inflammation.
- Wear proper shoes. Your doctor may recommend a shoe that's especially suited for your foot type, your stride and your particular sport.
- Try shock-absorbing insoles. These off-the-shelf shoe inserts — often made of cork, plastic, rubber or a gel-like substance — fit inside your shoes to help cushion shock.
- Use metatarsal pads. These off-the-shelf pads are placed in your shoes just ahead of the metatarsal bone to help deflect stress away from the painful area.
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Consider arch supports. If insoles don't help, your doctor may recommend arch supports to minimize stress on the metatarsal bones and improve foot function. Off-the-shelf arch supports come in various sizes and can be fitted immediately. More durable arch supports can be custom-made from a foam mold or plaster cast of your foot.
Rigid arch supports are made of a firm material such as plastic or carbon fiber. They're designed to control motion in two major foot joints below your ankles. Semirigid arch supports are made of softer materials such as leather and cork reinforced by silicone. Arch supports designed to treat metatarsalgia may include metatarsal pads, too.
If conservative treatments fail, in rare cases surgery to realign the metatarsal bones may be an option. If you're considering foot surgery, discuss the benefits and risks with your doctor.
- Maguire S. Metatarsalgia. In: Frontera WR, et al. Essentials of Physical Medicine and Rehabilitation: Musculoskeletal Disorders, Pain, and Rehabilitation. 2nd ed. Philadelphia, Pa.: Saunders Elsevier; 2008. http://www.mdconsult.com/das/book/body/208746819-6/0/1678/0.html. Accessed Dec. 9, 2010.
- Metatarsalgia. The American College of Foot & Ankle Orthopedics & Medicine. http://www.acfaom.org/metatarsalgia.shtml. Accessed Dec. 9, 2010.
- Bunions. American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=A00155. Accessed Dec. 9, 2010.
- Morton's neuroma. American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=A00158. Accessed Dec. 9, 2010.
- Mann JA, et al. Foot & ankle surgery. In: Skinner HB. Current Diagnosis & Treatment in Orthopedics. 4th ed. New York, N.Y.: McGraw-Hill Medical; 2006. http://www.accessmedicine.com/content.aspx?aID=2321820. Accessed Dec. 9, 2010.
- Callahan LR, et al. Overview of running injuries of the lower extremity. http://www.uptodate.com/home/index.html. Accessed Dec. 9, 2010.
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