How do you Fix Metatarsalgia?

There are many treatment options available to fix Metatarsalgia.  It is important to understand that Metatarsalgia simply means “Pain in the Metatarsals”.  What is important to know is WHAT anatomical structure is injured and causing your metatarsal pain?  Some of the structures that can be damaged and cause pain in the metatarsal region are the joint capsule (Capsulitis), Plantar Plate Ligament (Tear or Sprain), metatarsal bone (Bone marrow edema or stress fracture) and a Morton’s Neuroma (Inflamed nerve between the toes).  It is critical to have an accurate diagnosis so that you can choose how to fix Metatarsalgia.  Some Metatarsalgia treatments are more conservative than others, some are more effective and still some are more expensive than others.  If caught and treated early Metatarsalgia will usually resolve with inexpensive and simple treatments.

Fix Metatarsalgia byRemoving the Aggravating Variable

To fix Metatarsalgia remove the variable that is either causing your Metatarsal pain or contributing to it.  For example; if running is irritating it and you keep running it will worsen and can lead to permanent damage to your Joint Capsule, Plantar Plate ligament or bone.  Another example would be high heels.  If high heels are aggravating your Metatarsalgia then you must stop wearing them, at least until it heals. In other words if you have a rock in your shoe you must remove it or you will not get better.  This is the first step in how you fix Metatarsalgia.

Image result for rock in shoe

You can’t fix Metatarsalgia unless you remove the cause

Fix Metatarsalgia with Rest

Rest from activity, especially those activities that require running, jumping, walking or any other weight bearing activity.  If you are on your feet at work and this aggravates your Metatarsalgia it may be necessary to take time off or request a modified job position until you heal.  No amount of ice or Ibuprofen will help if you continue aggravating your Metatarsalgia.  This is the second step in how you fix Metatarsalgia.

Do I need Crutches to Fix Metatarsalgia

It may be necessary to be non-weight bearing to fix your Metatarsalgia.  This will usually be dictated by the severity.  Crutches are cheap and effective.  Other methods include wheelchairs, knee scooters and Peg-Legs.

Crutches for Metatarsalgia

Modern day Peg-Leg to Fix Metatarsalgia

Do I need a Walking Boot for Metatarsalgia

Instead of crutches a walking boot that has a stiff soled rocker bottom might be your best option.  There are many types and varieties of walking boots but the variable that makes them effective in treating Metatarsalgia is a stiff soled, rocker bottom which prevents loading and flexing the Metatarsal region.  As your Metatarsalgia heals it might be possible to transition to a rocker bottom walking or running shoe.  This is the third step in how to fix your Metatarsalgia.

Walking boot for metatarsalgia

Rocker bottom boots and shoes reduce the pressure on the Metatarsal Region

Over the Counter Orthotics to fix Metatarsalgia

Over the counter orthotics are a cheap but usually ineffective method to fix Metatarsalgia.  If the over the counter orthotic is going to have a chance at being effective it must have a metatarsal pad and must be comfortable.  If the orthotic or metatarsal pad irritates the metatarsal region you will not be able to heal.  Finding the right orthotic with a metatarsal pad that is both comfortable and effective is the fourth step in how to fix Metatarsalgia.  If this step fails you should consider the next step, custom orthotics.

If you have tried met-pads in the past and they were painful they were most likely too hard, too high or not placed properly,.  San Diego Running Institute can place metatarsal pads into your current uncomfortable and ineffective over-the-counter orthotics.

insoles for metatarsalgia

SDRI can modify your insoles to fix Metatarsalgia

Can Custom Orthotics Fix Metatarsalgia

Custom orthotics can be an effective in fixing Metatarsalgia.  In order to be effective, they must fit into your shoes, be comfortable and have a metatarsal pad as part of the custom orthotic design.  Proper height, size, density and location of the metatarsal pad is critical to it being effective.  If you have custom orthotics that are uncomfortable, do not fit into your shoes or aggravate your metatarsal region you will be unable to heal. If you have an uncomfortable or ineffective pair of custom orthotics either without a metatarsal pad or with an uncomfortable metatarsal pad they may be able to be modified for a fraction of the cost off new custom orthotics. San Diego Running Institute charges $167 to modify your existing orthotics and make them both comfortable and effective.  Custom orthotics are the fifth step in how to fix Metatarsalgia.

orthotics for metatarsalgia

A mold of your foot is not custom. In this case notice the custom placed metatarsal pad. What you do to an orthotic mold makes it custom. In this case precise placement of the metatarsal pad

Fix Metatarsalgia with Metatarsal Pads

Metatarsal pads can be effective in fixing Metatarsalgia.  Height, density, size and proper placement are critical for the metatarsal pad to be effective.  There is a proven and scientific method to ensure proper placement of the metatarsal pad.  Once placed the metatarsal pad can serve to raise, support and offload the Metatarsal region allowing it to heal.  If the metatarsal pad is uncomfortable or aggravates the Metatarsals it will be unable to heal.   Choosing the correct metatarsal pad and proper placement is combined with either over-the counter-orthotics or custom orthotics but can also be placed directly on the existing insoles in your shoes. But it must be placed in the precise location to be effective and comfortable.  San Diego Running Institute can help you choose the correct metatarsal pad and place it in the precise location.  Placing a metatarsal pad can be either the fourth, fifth or sixth step in how to fix Metatarsalgia.

Fix Metatarsalgia

proper height, size and density of the Metatarsal Pad is necessary to fix Metatarsalgia

Can Taping Fix Metatarsalgia

Taping can be effective in treating Metatarsal condition’s if there is joint deformity or deviation of the toe.  Typically, the second toe will deviate towards the big toe in severe cases of Plantar Plate Sprains.  This is also called Pre-Dislocation Syndrome.  A common but ineffective taping procedure tapes the second toe to the third and is called “Buddy Taping”.  This is not recommended as it pulls the third toe towards the second.  There is a more effective method of taping that utilizes Kinesiotape and only tapes the affected joint capsule into proper alignment.  San Diego Running Institute can teach you how to properly tape your toe and care for your Metatarsalgia.  Taping is the seventh step in how to fix Metatarsalgia.

taping for metatarsalgia

We can teach you to tape for Metatarsalgia

Ultrasound to Fix Metatarsalgia

Ultrasound can be an effective treatment for Metatarsalgia when combined with some or all the above interventions.  Ultrasound can be used to break up scar tissue and increase blood flow into the metatarsal joints, joint capsules, tendons and ligaments.  Ligaments, tendons and joint capsules are notorious for having a lack of blood flow.  Blood is required for these structures to heal.  When other conservative methods have failed Ultrasound, treatments are your next step in how to fix Metatarsalgia.  At San Diego Running Institute we routinely employ ultrasound to fix Metatarsalgia.

therapeutic ultrasound

Ultrasound is a key component in fixing Metatarsalgia


Alter Gravity Treadmill (AlterG)

The AlterG is one of the most modern and effective treatments for Metatarsalgia and allows the patient to run or walk while their Metatarsalgia is healing.  The AlterG does this by “unweighting” a person until there is not enough pressure on the Metatarsal structures to cause pain.  Once this is achieved the patient can run or walk without aggravating the Metatarsalgia.  This allows them to keep up their cardio, continue to train for an event and stimulates blood flow into the metatarsal structures (joint capsule, tendons, ligaments) to speed healing.  The AlterG has become one of our best interventions in how to fix Metatarsalgia.

Anti Gravity Treadmill for foot pain

Kobe Bryant rehabilitating on the AlterG

Do Cortisone Injections Fix Metatarsalgia

Cortisone is not recommended for Metatarsalgia.  Cortisone is a catabolic hormone meaning it breaks things down (as opposed to an anabolic hormone that builds tissue).  While it does break down inflammation it also breaks down tissue, in this case your joint capsules, tendons and ligaments.  This can cause long term damage to the metatarsal structures and is therefore not recommended.

cortisone for metatarsalgia

Cortisone should not be used to fix Metatarsalgia

Do I need Surgery to Fix Metatarsalgia

Surgery is not usually necessary in how to fix Metatarsalgia.  However, if you go to a surgeon and they recommend surgery……. what did you expect.  The Metatarsal structures (Joint Capsules, Plantar Plate Ligaments, Tendons and bone), if treated conservatively will almost always heal and not require surgery.

post foot surgery


If you need more information about how to fix Metatarsalgia please email or call San Diego Running Institute at 858-268-8525.