Metatarsalgia
Inflammation at the Ball just behind the Toes
Metatarsalgia can be localized under the first toe. There are two small sesamoïd bones under the first joint creating pressure, which can cause the pain.
But most often it is localized under the 2nd metatarsal head due to excess pressure either the 2nd toe is longer than the 1st (Morton’s Foot) and the pressure is transferred to the 2nd or hypermobility of the first ray while the 2nd stabilizes the foot.

Localized under the 2nd Metatarsal Head
Morton’s Neuroma
It is sometimes a little difficult to differentiate between a Morton’s Neuroma, Metatarsalgia and Capsulitis. Some people experience a shooting pain on the top aspect of the foot between two toes. Others describe the feeling like having a pebble in their shoe and sometimes experiencing a burning and/or numbness sensation up to the toes. Direct pressure between the metatarsal heads or between the metatarsals themselves will replicate the symptoms, as will compression of the forefoot. When moving the metatarsals in an up and down motion while compressing the forefoot, you might hear or feel a clicking sound (Mulder’s Click).
This determines that there is a strong possibility of a Morton’s Neuroma and irritation of the nerve caused by the constant movement of the metatarsals while walking. A custom foot orthotic along with a metatarsal pad usually suppresses the irritation and the pain. If more intervention is needed a Corticosteroid injection can relieve the inflammation and help to end the symptoms in some patients.
When all treatment fails, surgery in removing the irritated portion of the affected nerve (neurectomy) is recommended.
Consult your Medical Doctor if you have any questions
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