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Metatarsalgia – what is it and how is it treated?

Fifth metatarsal metatarsalgia – “Why does the outside of my foot hurt?”

Metatarsalgia fifth metatarsalPain specific to the outside, or lateral, aspect of the foot is a common condition called metatarsalgia.  The term metatarsalgia is used to describe vague, aching pain specific to the metatarsal bones.  Metatarsalgia can describe midfoot pain, lateral foot pain, and forefoot pain.  Let’s take a closer look at lateral foot pain caused by 5th metatarsal metatarsalgia.

The foot and all of its 27 bones and 115 ligaments are designed to work as a team with each of the bones and ligaments pulling their own weight. Metatarsalgia is caused by excessive load being carried disproportionally by one bone of the foot. Simply put, metatarsalgia happens when one metatarsal bone does more work than it can manage long-term.

Fifth metatarsal metatarsalgia can be caused by a unique structural position of the foot knownCalcaneal varus as rearfoot varus. The following image shows a normal heel or rectus heel (left) and an inverted or varus heel (right.) From this image, you can see how rearfoot varus will result in excessive load being applied to the lateral, or outer, border of the foot.

Rearfoot varus is a contributing factor to fifth metatarsal metatarsalgia, peroneal tendon injuriesperoneal tendon subluxation, and chronic ankle sprains.

Treatment of rearfoot varus, fifth metatarsal metatarsalgia, peroneal tendon injuries, and even chronic ankle instability can usually be accomplished with the use of simple in-shoe wedges:

Lateral sole Wedge InsertsLateral Sole Wedge Inserts are inexpensive, easy to use, and can be trimmed with scissors to fit most shoes. Lateral Sole Wedge Inserts provide a 5-degree lift to the outer foot, helping to limit both rearfoot and forefoot varus.

Rubber Heel WedgesRubber Heel Wedges also help to control rearfoot varus. Simple and effective, Rubber Heel Wedges fit easily into all shoes.

Premium Heel WedgesPremium Heel Wedges are the same as our Rubber Heel Wedges but come with a finished leather top cover.

Heel Wedges PPTPPT Heel Wedges offer a softer and more subtle bit of control with similar wedge technology.

Additional teatment recommendations - Lateral foot pain due to metatarsalgia can be treated with any of these shoe inserts. Additional treatment recommendations include:

  • Avoid high-heeled shoes
  • Wear shoes with a rigid shank


Dr. Jeffrey Oster
Jeffrey A. Oster, DPM

Medical Advisor

Updated 12/24/2019

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