Management of metatarsalgia with foot orthotics.

Various disorders cause pain in the forefoot. Factors contributing to the development of metatarsalgia include: biomechanical alignment, foot biomechanics, anatomical structure of the foot and leg, physical activity, and pathological disease states. The foot functions to balance and support forward locomotion by acting as a mobile adaptor to the ground and as a rigid lever during propulsion at the early and late phases of stance. Forefoot pathomechanics results from an overload of the anterior support or from an irregular distribution of the metatarsal weightbearing load. Orthotic therapy may be provided with insoles made from flexible, semiflexible, or rigid materials. The orthotic should be individualized in each patient's case. The purpose of treatment is to increase weightbearing tolerance by balancing the metatarsal load, assisting proper foot biomechanics, and cushioning or protecting the metatarsal heads. J Orthop Sports Phys Ther 1985;6(6):324-333.