Foot orthoses modified with metatarsal pads, the current standard of care for metatarsalgia, don’t significantly reduce plantar pressure compared with orthoses alone, according to a study presented in July at the annual APMA meeting in Boston.
Researchers from the California School of Podiatric Medicine in Oakland noted that although metatarsal pads commonly used for metatarsal offloading and pain relief, few studies have compared this intervention with other modalities that offload the forefoot.
The investigators evaluated plantar pressure in 39 women without a history of metatarsal pain under four treatment conditions: shoe alone; prefabricated forefoot orthotic alone; prefabricated orthotic with metatarsal pad; and prefabricated orthotic with intrinsic metatarsal bar.
Compared with the shoe alone, all orthotic conditions significantly reduced forefoot plantar pressure. The prefabricated orthotic with metatarsal pad conferred the lowest plantar pressure value, reducing pressure by 4.8% more than the prefabricated orthotic with intrinsic metatarsal bar, the intervention that produced the second-greatest pressure reduction. The differences between orthotic conditions, however, were not statistically significant.