Lesser Metatarsophalangeal Joint Instability: Nonsurgical Treatment Alternatives

Lesser metatarsophalangeal (MTP) joint instability can cause pain in the MTP joints with ambulation. The goal of nonsurgical treatment is to offload the metatarsal heads and stabilize the MTP joints. Achilles stretching can be effective by decreasing pressure in the forefoot with ambulation. Metatarsal offloading does not stabilize the lesser MTP joints but can alleviate pain in the plantar surface of the metatarsal heads. Crossover taping and strapping can stabilize the MTP joint and resist MTP hyperdorsiflexion. Steroid injections can alleviate inflammation but is also associated with further attenuation of the ligamentous structures that stabilize the MTP joint.