Metatarsalgia - Treating metatarsalgia

Most cases of metatarsalgia will respond well to a number of self-care techniques. These are discussed below.

RICE

RICE stands for:

• Rest – avoid regular exercise and reduce your daily physical activity. Using crutches or a walking stick may help if you cannot put weight on your foot.
• Ice – apply an ice pack to the affected foot for 10 to 30 minutes. A bag of frozen peas, or something similar, will work well. Wrap the ice pack in a towel to avoid it directly touching your skin and causing ice burn.
• Compression – use elastic compression bandages to limit swelling.
• Elevation – keep the injured foot raised above the level of the heart. This may also help to reduce swelling.

After 48 hours of RICE therapy, stop compression and try moving the injured area. If after this time your symptoms are worse, seek advice from your GP.

Other measures

You can try the following measures to ease the pain of metatarsalgia:

• change your style of shoe to something more roomy and flat-heeled
• avoid activities that make your symptoms worse
• use shock-absorbing insoles – these can be fitted inside your shoes to help cushion the pressure when walking
• take paracetamol and non-steroidal anti-inflammatory (NSAIDs), such as ibuprofen – these can help prevent inflammation and ease pain
• use orthotics (specially fitted insoles) – these are designed to improve foot function, redistribute pressure and protect the ball of the foot
• exercise your ankle and stretch your Achilles tendon (tendon at the back of the ankle)

More severe cases

If the above measures have not helped, see your GP. They may give you further advice or refer you to another healthcare professional.

Simple treatments can include shaving hard areas of skin or steroid injections into your foot joints to reduce the inflammation. Steroid injections may cause some pain and swelling at the site of the injection, but this should pass within a few days.

Read more about corticosteroids.

Surgery

Depending on the cause of your metatarsalgia, you may be referred to an orthopaedic foot and ankle surgeon to consider an operation to treat the underlying condition. Surgery may aim to:

• straighten a hammer toe (where the toe is bent and no longer moves normally)
• reshape or shorten prominent metatarsal bones
• release a trapped nerve or remove an irritated nerve