Metatarsalgia is not an actual medical diagnosis. It is a descriptive term for pain in the metatarsal area, which is in the ball of the foot behind the toes. There are a number of anatomic structures that can be injured or have abnormalities which can result in pain in the metatarsal area. The 3 most common are Morton’s neuroma, metatarsal joint capsulitis and great toe sesamoiditis. Morton’s neuroma is a syndrome of one of the nerves that run from inside the bottom of the foot into the toes. The nerve gets pressed on the ligament between the metatarsal bones with weight bearing and becomes inflamed resulting in pain that can radiate into the toes. Sometimes, a clicking sensation can be felt when pressing over the nerve or with walking. Metatarsal joint capsulitis is an inflammation of the soft tissues surrounding one or more of the joints between the metatarsal and toe bones. It is caused by abnormal pressure under the area with weight bearing. This can be due to factors such as an abnormal position of the metatarsal, high heel wearing, repetitive trauma or pressure shift from a bunion deformity. Sesamoiditis is an inflammation of a tiny accessory bone beneath the great to joint. This can be caused by either acute or chronic trauma to the area during weight bearing. Diagnosis of these or any other metatarsal area condition is usually arrived at with detailed history, careful physical examination and diagnostic imaging(x-rays, ultrasound, MRI). Like any other medical problem, early intervention results in faster healing. Equally as important is identifying the causative factors and managing them to prevent recurrence. Should you have pain in the ball of the foot that doesn’t respond to self care or keeps coming back, come in for a visit and we will get to the bottom of the problem(no pun intended).