Inclusion Criteria:  Age 18 - 75 years. Women of childbearing potential must have a negative serum or urine pregnancy test results within 24 hours before the first dose of ketorolac. Primary elective great toe MTP arthrodesis (CPT 28750). Other forefoot procedures often performed in conjunction with toe fusion will be included (CPT codes 28308, 28285, 28270).  Exclusion Criteria:  Chronic pain syndrome, CRPS or fibromyalgia Revision procedures Use of allograft bone at the fusion site Tobacco use Diabetes Narcotic abuse or IV drug abuse Any CPT codes involving the midfoot, hindfoot, and/or ankle Unable to take NSAIDs secondary to medical comorbidities such as kidney disease (impaired renal function with CrCl ≤ 50 ml/min) or gastric ulcers Weight < 50 kg Does not speak or read English If pregnant or planning to become pregnant or breastfeeding Non-independent dweller (prisoner)