Metatarsalgia

Diagnosis/Definition

• Idiopathic pain on the plantar aspect of the ball of the foot.

Initial Diagnosis and Management

• History and physical examination.
• Appropriate weight-bearing foot x-rays and laboratory studies (Rheumatology panel evaluation if inflammatory, bilateral, and accompanied by other joint symptoms).

Ongoing Management and Objectives

• Initial primary care treatment should consist of a three-month trial of the following: NSAIDs, over-the-counter soft insoles (i.e., Spenco), soft supporting shoes with a wide toe box (running or walking type), decreased activity (rest).

Indications for Specialty Care Referral

• Patients without improvement of symptoms after the three-month trial period can be referred to the Podiatry Clinic.
• All Retiree's, VA and dependents with foot conditions 30, 31, 01, 02, 03, 04 etc.. Respectfully need to be routed to Schofield Barracks Podiatry or net worked out for treatment. Tripler Podiatry unfortunately does not provide orthotics or inserts for dependents, VA or Retiree's.

Criteria for Return to Primary Care

• Patients will be returned to primary care for chronic management after biomechanical/orthotic management (non-surgical candidates) or surgical treatment is complete.