Metatarsalgia: Clinical Profile and Comfort from Foot Orthoses Treatment

Abstract

ABSTRACT Introduction The biomechanical factors influencing metatarsalgia etiology have been well documented; however, patient characteristics of individuals suffering from this condition and the effectiveness of foot orthosis therapy remain unknown. Objectives The objectives of this study were 1) to characterize the metatarsalgia profile of patients seeking treatment in a footwear and orthotic clinic, and 2) to explore the association between comfort and pain in patients with metatarsalgia who were treated with foot orthosis intervention. Study Design This study is a retrospective chart review. Methods Metatarsalgia assessment and follow-up data (case group n = 2137) were extracted from a research database (control group n = 82,822) from patients visiting a private foot care clinic. A clinical assessment was performed by a Canadian-certified pedorthist, and footwear recommendations and bilateral custom foot orthoses were provided to all patients. Feet were casted using a three-dimensional volumetric laser scanner. Orthoses (80% of cases) were manufactured from a direct mill polypropylene shell; additional rearfoot, forefoot postings, and/or metatarsal support was added according to the patient’s personalized treatment plan. Results Eighty-one percent (81%) of metatarsalgia patients reported symptom improvement following custom orthoses treatment. The average pain reduction from the orthotic intervention was 58.55%. The average self-reported comfort scores were 7.7 ± 2.2/10 at follow-up. Compared with our control group, patients with metatarsalgia were more frequently self-identified as females, over 51 years of age, and the condition was observed in a higher prevalence of high cavus feet. Conclusions Our results suggest that a pes cavus foot posture is a biomechanical risk factor to the development of metatarsalgia. Custom foot orthoses that are manufactured according to a patient’s personalized treatment plan are an effective conservative treatment option for pain reduction in patients suffering from metatarsalgia. Clinical Relevance Statement Foot orthoses are an effective conservative treatment option for pain reduction in metatarsalgia patients.