Non-surgical management is almost always the first line of action, unless there is serious risk to health such as infection or possible tumour.
- Non-surgical management aims:
to educate patients about the causes of foot pain - to encourage patients to take good care of their own feet
- to reduce pain and skin problems caused by pressure between toes and on shoewear
- to control pain under the metatarsal heads and MTP joints by redistributing weight to other parts of the foot
- to reduce synovitis in the MTP joints
The main non-surgical interventions are:
- Explanation and advice
- Simple analgesia or non-steroidal medication for synovitis (some patients will need referral to a rheumatologist for more complex management of inflammatory arthritis)
- strapping or injections for MTP synovitis and instability
- shoes with enough room in the toebox to accommodate the toes - these may be obtained from commercial shops once the patient understands what is required, or provided by the orthotist
- metatarsal dome insole to relieve sub-metatarsal pain