The most common location for metatarsalgia is under the ball of the foot, near the base of the second toe. Think of this problem as a stone bruise of the bottom of the second metatarsal head and its associated joint. The symptoms include pain under the ball of the foot without numbness or tingling. It might feel like you are stepping on a pebble with every step. There’s usually no pain or swelling on the top of the forefoot.

Metatarsalgia can be associated with abnormal foot pronation, loss of forefoot cushioning with shoe wear, using racing shoes with inadequate forefoot cushioning, or multiple foot strikes on pavement over the course of a marathon.

Self-care should include ice massage for 10 to 15 minutes twice a day until pain free; over-the-counter anti-inflammatory medications; over-the-counter insoles; and new shoes (if your current shoes already have significant mileage).