• Styloid Process Metatarsal pain is usually the result of excessive pressure exerted by a metatarsal bone on the soft tissues below it. This can be caused by abnormal pronation of the rearfoot. Excessive pressure causes injury to the soft tissue structures and overlying peroneus brevis tendon attachement.
  • Treatment options including padding with aperture pads or innersoles, use of flat shoes that lessen metatarsal pressure and surgical treatment were explained.
  • It was explained that surgery is only one option for treatment of metatarsal pain. Metatarsal pain may never require surgery and surgery is always elective. Accommodation and orthotics can make having a metatarsal pain tolerable.
  • Shock Wave Therapy

Pneumatic shock wave therapy will injure the tissue with pressure and start the healing process. Following the procedure that will take place in the office, Patient receives 4-5 weekly treatments until healing is achieved. Estimated time is 6 weeks.

  • Surgical correction was explained. Under sedation and local anesthesia at the hospital an incision is made over the bone. The tendon is peeled back away from the bone prominence, and the prominence is then cut and remodeled using a bone saw. The tendon is then resutered to its attachment. It was explained that the patient is required to walk in a surgical shoe or boot for at least two months. Healing usually takes 2 to 4 months.
  • Potential risks and complications were explained including, infection, painful or ugly scar, numbness, failure to heal, fixation failure and removal by another operation, over or under shortening of the bone leading to pain under an adjacent metatarsal bone, continued pain, and recurrence of deformity.

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