Metatarsalgia is the pain of the forefoot stem and bony surface (i.e., the bottom of the forefoot) caused by strain or nerve compression or irritation of the transverse arch of the forefoot, and is clinically divided into flaccid and compressive. Most of the flaccid metatarsalgia is congenital. It is mainly due to chronic injury to the transverse arch caused by congenital abnormal development of the first metatarsal bone, and is a primary metatarsal enthesopathy and bone hypermobility. Clinical manifestations: (1) pain on the forefoot surface during walking, which is persistent burning pain; (2) widening of the forefoot with callus on the second and third bone surfaces; (3) pressure pain on the surface, while lateral squeezing of the bone can reduce the pain; (4) abnormal activity of the first tarsal joint may occur with pain. Diagnosis based on: (1) persistent burning pain on the forefoot surface when walking, callus on the forefoot sole, pressure pain, while lateral squeezing of the bone can relieve the pain (2) widening of the gap between the first and second bones and inversion of the first bone can be seen on X-ray. Treatment principles: flaccid pain can often be effective by non-surgical treatment, and only very few require surgical treatment. Compressive dysesthesia is related to improper shoe wearing. It is caused by interstitial neuritis or neurofibroma due to long-term pressure or stimulation of the toe nerve caused by long-term extrusion of the bones by external forces, and is mostly related to the wearing of high-heeled shoes or narrow-headed shoes. Clinical manifestations: (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 long and thin, the forefoot has been squeezed phenomenon; (3) there is pressure pain on the surface, and lateral squeezing of the bone can aggravate or cause pain; (4) the third and fourth toes can have abnormal sensation. Diagnosis: (1) paroxysmal radiating pain on the forefoot surface during walking, radiating to the toes of the affected foot, with pressure pain on the surface, which can be aggravated or caused by squeezing the bone laterally. (2) A lump can be felt on the face of the third and fourth toe. The disease is mostly found in middle-aged and older women aged 30-50 years, and in those with narrow and lax feet, mostly unilateral. Treatment principle: surgical treatment is required with satisfactory results.