Metatarsalgia refers to pain in the metatarsal trunk of the forefoot and the metatarsal head-plantar surface (i.e., the bottom of the forefoot) caused by strain on the transverse arch of the forefoot or compression or irritation of the metatarsal nerve, and is clinically divided into flaccid and compressive. 1, flaccid metatarsalgia is mainly due to the first metatarsal bone congenital developmental abnormalities resulting in chronic injury to the transverse arch, for primary metatarsal entropion and metatarsal hyperactivity disorder. Clinical manifestations mainly include persistent burning pain on the metatarsal surface of the forefoot, callus on the bottom of the forefoot, metatarsal surface pressure and lateral squeezing of the metatarsal heads can reduce pain. 2, compression metatarsalgia is due to long-term extrusion of the metatarsal head by external forces resulting in interstitial neuritis or neurofibroma caused by long-term compression or stimulation of the toe nerve. For wearing high-heeled shoes or narrow-headed shoes. The clinical manifestation is paroxysmal radiating pain in the forefoot when walking, radiating to the adjacent toes, accompanied by abnormal sensation and pressure pain on the metatarsal surface, which can be aggravated or caused by lateral squeezing of the metatarsal head. The disease is most common in middle-aged and older women aged 30-50 years, and in those with narrow and lax feet, mostly unilaterally. Lax metatarsalgia can often be treated non-surgically, and only rarely requires surgery. Compression metatarsalgia requires surgical treatment with satisfactory results. The key to the treatment of this disease is to distinguish the cause of the disease. Clinical manifestations 1, flaccid metatarsalgia: (1) pain on the metatarsal surface of the forefoot when walking, persistent burning pain; (2) widening of the forefoot, callus on the metatarsal surface of the second and third metatarsal heads; (3) pressure pain on the metatarsal surface, while lateral squeezing of the metatarsal heads can reduce the pain; (4) abnormal movement of the first metatarsal tarsal joint, and pain. 2, compression metatarsalgia: (1) pain in the forefoot when walking, paroxysmal radiating pain, stabbing or cutting pain, pain radiating to the third and fourth toes, sometimes forced to stop walking or standing due to severe pain; (2) the affected foot is slender, the forefoot has been squeezed phenomenon; (3) there is pressure pain on the metatarsal surface, while lateral squeezing of the metatarsal head can aggravate or cause pain; (4) the third and fourth toes can have abnormal sensation. Diagnosis 1, flaccid metatarsalgia: (1) persistent burning pain on the metatarsal surface of the forefoot when walking, callus on the plantar surface of the forefoot, pressure pain, and lateral squeezing of the metatarsal heads can reduce the pain; (2) the X-ray film can see the widening of the gap between the first and second metatarsal heads, and the first metatarsal inversion. (2) compression metatarsalgia: (1) paroxysmal radiating pain on the metatarsal surface of the forefoot when walking, radiating to the toes of the affected foot, metatarsal surface pressure pain, lateral squeezing of the metatarsal heads can aggravate or cause pain; (2) masses can be felt on the metatarsal surface of the third and fourth toes. Treatment principles 1. Wear orthopedic shoes and apply transverse arch pads to restore and maintain the arch of the foot. 2.Strengthen the intrinsic foot muscle exercise: bounce in place, etc. 3.Physiotherapy hot compress or massage. 4, symptomatic treatment: such as taking anti-inflammatory and pain-relieving drugs or local closure. 5, long-term non-surgical treatment is ineffective, consider surgery. 6.The above is the treatment principle of flaccid metatarsalgia. 7.Compression metatarsalgia: (1) Remove the cause: do not wear narrow-headed shoes, high-heeled shoes, etc.; (2) Treat symptomatically; (3) Most of them require surgical removal of toe neuroma, and do not wear high-heeled shoes or narrow-headed shoes after surgery.