II. Definition
- Pain beneath Metatarsal head
III. Etiology
- Abnormally high arch
- Improper shoe selection
- High heeled shoes
- Tight Achilles tendon
IV. Associated Conditions
- Hammer toe (Claw toe)
- Hallux Valgus deformity
V. Symptoms
- Burning or cramping pain at Metatarsal heads
- Middle Metatarsal heads usually affected
- Symptoms worse with activity
- Relieved by rest
VI. Signs
- Tender calluses develop under Metatarsal heads
- Dorsal contractures of metatarsophalangeal joints
VII. Management
- See Proper Shoe Fit
- Hard soled shoe or cast for 4-6 weeks
- Casting especially indicated for fifth Metatarsal
- Transfer weight from Metatarsal heads to neck or shaft
- Low-heeled shoe with sufficient forefoot room
- Anterior Metatarsal bar
- Transfers weight behind Metatarsal heads
- Metatarsal pads
- Sorbothane pads
- Available at Running stores
- Visco Heels
- More expensive
- Trimming or paring callus with pumice stone
- Provides only temporary relief
- Pressures must be removed from Metatarsal heads
- Calluses disappear with time if pressure changed
- Warm soaks
- Surgery
- Indicated if conservative management fails