Most of the clinical treatments used to alleviate the symptoms of metatarsalgia are placed directly inside a patient's footwear. Therefore, to objectively evaluate these treatment methods, an in-shoe pressure system is the most appropriate measurement tool. The authors can find no published studies which assess the treatment modalities for metatarsalgia using an in-shoe foot pressure system. The vast majority of previous studies which investigated the use of orthoses in metatarsalgia have been carried out using barefoot measuring systems. In this study, an in-shoe pressure measurement system, GaitScan, has been used to evaluate two treatment modalities for metatarsalgia: a Foam-o-felt U-shaped pad and a metatarsal dome/button. 30 asymptomatic subjects were studied. From each subject 3 sets of pressure data were collected whilst the subject was wearing: (1) Orthofit shoes (control); (2) Orthofit shoes with a Foam-o-felt pad; and (3) Orthofit shoes with a dome/button insole. The results obtained indicated a more effective and significant pressure reduction (P <0.05) and redistribution using a dome/button when compared to the Foam-o-felt pad.