Both metatarsal pads and metatarsal domes are used to relieve forefoot pain — but they're shaped differently, placed differently, and suited to different conditions. Choosing the wrong one can make pain worse rather than better. Here's the clinical distinction.
What is a metatarsal pad?
A metatarsal pad is a flat or gently contoured pad placed just behind (proximal to) the metatarsal heads — the bony prominences at the ball of the foot. Its job is to spread the metatarsal heads apart and redistribute pressure away from a painful area. The key word is "behind" — the pad sits proximal to the pain, not directly under it.
Metatarsal pads are typically flat or teardrop-shaped and made from felt, foam, or gel. They're commonly used for Morton's neuroma, metatarsalgia (general ball-of-foot pain), and capsulitis, where the goal is to lift and separate the metatarsal bones to reduce compression on the nerves and joints between them.
What is a metatarsal dome?
A metatarsal dome is a raised, dome-shaped device that sits under the transverse arch of the foot, supporting the metatarsal shaft area. It's taller and more three-dimensional than a flat pad, and its primary function is to restore the natural transverse arch that collapses under load — particularly in flat feet, forefoot valgus, and splayed forefoot conditions.
Our range:
- Trekker Metatarsal Dome — firm EVA dome that adheres to the underside of an orthotic or insole. Provides strong structural support for the transverse arch.
- Formthotics Metatarsal Dome Pads (Pack of 5 Pairs) — self-adhesive foam domes available in two sizes and two heights for customised placement.
When to use a metatarsal pad
- Morton's neuroma — the pad spreads the metatarsal heads apart, reducing compression on the interdigital nerve
- Metatarsalgia — redistributes pressure away from the painful metatarsal head(s)
- Capsulitis of the second toe — offloads the inflamed joint capsule
- Calluses under the ball of the foot — redistributes the pressure causing the callus
When to use a metatarsal dome
- Collapsed transverse arch — the dome physically supports and restores the arch shape
- Splayed forefoot — lifts the metatarsal shafts to reduce the width of the forefoot under load
- Forefoot pain combined with flat feet — the dome works alongside longitudinal arch support from an orthotic like a Trekker to control both arches
- As an add-on to existing orthotics — both Trekker and Formthotics domes are designed to adhere to the underside of an orthotic for combined longitudinal and transverse arch support
Placement matters
The most common mistake with both pads and domes is placing them too far forward — directly under the metatarsal heads rather than just behind them. If the pad or dome sits under the painful area rather than proximal to it, it increases pressure on the already irritated structures and makes pain worse. Your podiatrist can mark the correct placement position on your orthotic or insole.
Quick comparison
- Flat, spreads metatarsals apart → metatarsal pad
- Raised, supports the transverse arch → metatarsal dome
- Morton's neuroma or nerve compression → pad
- Collapsed transverse arch or splayed forefoot → dome
- Can I use both? → ask your podiatrist — in some cases a dome with a pad extension is used for combined correction
Browse our full range of orthotics, insoles and metatarsal supports →