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Treating Metatarsalgia With Insoles and Other Orthotic Devices

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By Janik Sundstrom
Joel Taylor
Edited by Joel Taylor

Updated January 30, 2024.

A woman's hands sliding on a gel metatarsal pad to aid treatment of Metatarsalgia

Metatarsalgia is the most common condition of the forefoot (the ball of your foot), whereby inflammation and pain may lead to reduced activity in severe cases. In this condition, pain originates from the metatarsal heads of the outside of the foot after being put under abnormal loads.

The condition is usually not serious, and adaptations can be made to remedy it, preventing future symptoms from occurring.

This article looks at the different types of metatarsalgia and how to treat the condition with the use of orthotic insoles.

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Types of Metatarsalgia

Primary Metatarsalgia

Primary metatarsalgia results usually from anatomical abnormalities that occur in the foot that alter the distribution of forces under load. Conditions affecting the forefoot structures such as bunions (hallux valgus) and arthritis of the big toe (hallux rigidus) cause most of the force to be transferred through the smaller toes, causing inflammation and pain.

Flat feet (pes planus) or a rigid arch also fall under the primary classification.

Secondary Metatarsalgia

Secondary metatarsalgia results from increased loading due to indirect causes brought about by systemic conditions that affect this area of the foot, not the metatarsals themselves.

Rheumatoid arthritis, systemic lupus erythematosus, Morton’s neuroma (nerve compression due to footwear that is too tight), gout, and stress fractures are all examples of secondary metatarsalgia. 

Other causes include leg length discrepancies, scoliosis, and kyphosis caused by increasing forces applied through the outside metatarsal heads.

How Does Orthotic Therapy Help Metatarsalgia?

Orthotics can play a significant role in shock and pressure reduction to the forefoot structures when walking, running, or jumping, making them a widely accepted treatment for metatarsalgia. Increased shock absorption qualities gained through wearing orthotics decrease the load through the ankle, knee, and hip joints, playing a vital role in decelerating the cartilage breakdown leading to arthritis over time.

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Which Orthotic Treatments Help Metatarsalgia?

Metatarsal Pads

Metatarsal pads are applied behind the ball of the foot to provide pain relief by offloading the structures responsible for the pain and distributing the force through the rest of the foot structures. Improved functional ability will result through the redistribution of force away from the inflamed areas, leading to pain reduction. 

Placement of these pads is important and will ensure that they are beneficial to improving your condition. Placing the pad right behind the ball of your foot, the soft region behind your toes, is key to ensuring that metatarsal arch structures are supported when forces are applied.

When applying the metatarsal pad, attempt to stand and walk with it on; you should experience a drastic relief in pain. Should the pain increase with the pad, adjust its position and try again until you find relief. 

Supportive Insoles

Supportive insoles are usually bought over the counter or online according to your shoe size. Custom orthotics purchased from a specialist and tailored to your feet are always recommended over generic insoles.

Typically, the foot pronates (turns inwards), and the transverse arch flattens out. Supportive insoles prevent the foot from turning inwards (pronation) and flattening by providing enough support to the arch when weight is applied.

Repetitive impact forces applied through the foot will increase the risk of developing metatarsalgia, especially in runners and high-impact sports like basketball. Runners would benefit greatly from increased shock absorption, support, and cushioning.

However, not only athletes will find benefit from the use of orthotics. Nowadays, with footwear choices not always keeping functionality in mind and rather the looks thereof, it is ever more important to provide your feet and body with adequate support through a range of daily activities by using supportive insoles.

Preventing pressure areas in the foot through the use of supportive insoles will provide a great sense of comfort to those wearing them.

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Are Orthotics Enough to Treat Metatarsalgia?

Orthotics are vital in treating symptoms related to metatarsalgia but should be used in conjunction with other treatment methods. While you are considering the adoption of insoles for flat feet especially into your shoes, ensure the shoes you are wearing to do exercise or daily activities have enough toe space, fit well, and have a low heel.

For quality orthotics tailored to your feet, visit our online store to receive your impression kit and treat your pain.

Other than orthotics, include the following remedies for maximum benefit and chance of recovery:

  • RICE (Rest, Ice, Compression, Elevation)
  • Medication in those who experience severe pain

» Worried about your metatarsalgia? Find out whether the condition ever goes away.

In cases where the severity of the condition may be such that you cannot walk or experience pins and needles, seek medical advice from a foot specialist or any medical practitioner. Management of the condition thereafter will be decided upon based on the severity and duration of symptoms experienced. 

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