Metatarsalgia

Symptoms and signs

Not a true condition but refers to pain felt generally under the metatarsals.

Can be caused by:

MTP joint synovitis/ instability
Intermetatarsal bursitis
MTP joint arthritis
Painful plantar callosities
March fracture
Morton's neuroma

Initial management

Footwear advice (avoid heels and tight-fitting shoes)
Analgesia & NSAIDs as appropriate.
Advise weight loss if appropriate

Primary Care diagnostics

If not settling arrange Radiographs. Foot AP standing, lateral and oblique views

Useful resources

Metatarsalgia patient information leaflet.

Who to refer

Those with no improvement three months with persistent pain and deformity.

Who not to refer

Surgery is not offered for cosmesis.

How to refer

SCI Gateway/Orthopaedics/Foot & Ankle Service.
Referrals will be vetted by an AHP and directed to the most appropriate healthcare professional.

Information to include when referring:

Duration and any cause of symptoms
Indicate site/spread of pain and if pain constant or intermittent, and/or waking at night
Indicate ROM, functional loss, effect on walking, work/hobbies/sports
Include treatment to date
XR results