Metatarsalgia - Treatment

Medical therapy:Nonsteroidal anti-inflammatory agents such as ibuprofen are useful for pain relief.
Physical Therapy:Initial treatment includes application of ice acute phase and a pressure bandage. It is recommended outpatient without applying pressure on the foot in the first 24 hours, then ultrasonic treatment can be initiated and the physical. The use of metatarsal pads and appliances ortotice bring relief of symptoms.The patient should avoid disruption of healing. You have to perform stretching and resistance exercises carefully. Its return to sports activities is gradual.In the recovery phase once the patient no longer shows the pain will start stretching exercises isometric, isotonic and izokinetice.Passive exercises can progress to active ones as inflammation resolves. Therapy improves progression increased anterior tibial dorsiflexiei ball of your foot to reduce stress in the latter. Stretching flexors allow greater mechanical support of the fingers.
Surgical therapy:In cases in which conservative therapy failed to relieve symptoms, surgery may be necessary: ​​Synovectomy, arthroplasty, osteotomy of the metatarsal bases, release ligament and tendon transfer.Metatarsal pain can be relieved successfully by specific osteotomies. Callus removal is not recommended because it is a response to pressure and not primary disease. Temporary improvement in symptoms can be accepted by shaving the callus.If patient symptoms are acute and short-term primary etiology may be abnormal pronation of subtalar joint. Ortotice devices are used in these cases. Chronic symptoms respond better to drag metatarsal to be added to the athletic shoe.People with pes Cavus answer ortotice devices that make full contact with a longitudinal metatarsal arch preventing its collapse and reduce stress on the metatarsal heads.
Prevention:Prevention should target the elimination of friction or abnormal pressure. You can use ortoze, metatarsal pads and callus care to prevent mechanical and muscular imbalances. Callus care includes debridement by shaving.