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  • Metatarsals are the long bones in the feet.  1st ray is the metatarsal in line with the big toe.  The 5th metatarsal is the metatarsal in line with the little toe.

  • Metatarsalgia is pain of the forefoot brought about by abnormal foot biomechanics.

  • Also referred to as metatarsophalangeal joint synovitis.

  • Can involve an increased shearing load placed on the transverse ligaments and intrinsic muscles of the foot.  This can result in inflammation of the metatarsophalangeal joints (MTP).

Signs & Symptoms

  • Pain in the forefoot

  • Aggravated by weight-bearing

  • Pain comes on gradually

  • Joints are tender to touch

  • The 2nd MTP joint is the most commonly affected

  • Callous may be present under the affected joint

What Causes It?

  • Excessive pronation

  • Hallux valgus

  • Hypermobility of the foot

  • Clawed foot

  • Rigid foot

How to Self Manage

  • R.I.C.E. Protocol

  • Anti-inflammatory medication for short term pain relief (if not contraindicated)

  • Wear activity-appropriate footwear, with cushioning.


  • If conservative management a corticosteroid injection may be required to settle the pain and inflammation.

  • X-ray may be useful to determine the degree of bony stress and degeneration.

How Physio Helps

  • Assessment to identify contributing biomechanical factors

  • Electrotherapy

  • Joint mobilisation

  • Padding to redistribute loading

  • Strapping

  • Podiatric referral if necessary

  • Prescription of exercises to strengthen the intrinsic muscles

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