University of Iowa Family Practice Handbook, Fourth Edition, Chapter 16

Orthopedics: Foot Pain

1. Metatarsalgia. Pain on weight bearing in the anterior foot with tenderness over the plantar aspects of the metatarsal heads. Pain is exacerbated with wearing high heeled shoes. It is increasingly common as patient’s age with loss of the normal foot fat pads. Treatment is NSAIDs and a metatarsal pad that restores the normal convex contour of the foot and takes the pressure off of the metatarsal heads. These are available at most drug stores or orthotic makers.
2. Differentiate from Morton’s neuroma, a neurofibrillary tangle between the metatarsals, especially 2 and 3 and 3 and 4 Pain is described as burning and is exacerbated with squeezing the anterior foot to compress the metatarsals together. Treatment is avoidance of extension of the toes and pain management. Surgical therapy has a good outcome and is frequently required.

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See related Provider Topics Bones, Joints and Muscles, Foot Injuries and Disorders or Injuries and Wounds.

See related Patient Topics Bones, Joints and Muscles or Injuries and Wounds.

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