For metatarsalgia, what level of orthotic rigidity is described as appropriate?

• A. No orthotic required
• B. Full length rigid or semirigid
• C. Partial length soft insert
• D. Flexible soft orthotic

Answer: (B)

For metatarsalgia, the aim of an orthosis is to offload pressure under the metatarsal heads by providing a stiff, supportive plantar surface that redistributes load and stabilizes the forefoot during gait. A full-length rigid or semirigid orthosis does this best because it covers the entire plantar surface, supports the arch, and limits forefoot motion enough to reduce repetitive loading at the met heads. Soft, flexible inserts, or partial-length or purely soft devices, don’t offer the same level of stabilization or pressure redistribution, so they’re less effective for this condition. Not wearing an orthotic at all leaves the forefoot under constant high pressure.