Metatarsalgia is pain on the metatarsal side of the metatarsophalangeal joint of the forefoot. Metatarsalgia is not a diagnosis, but can be caused by a variety of factors. Since bunion and little toe metatarsalgia have their own diagnoses, metatarsalgia is usually referred to as pain on the metatarsal side of the 2-4 metatarsal toe joints, also known as intermediate metatarsalgia. Treatment of metatarsalgia 1. Non-surgical treatment (1) Reduce activities. Avoid wearing thin-soled shoes and walking on hard surfaces for long periods of time. (2) For simple painful callus, you can go to the bath or use special scissors to cut or grind away the thickened callus, which can reduce the pain. But can not cure the root of the metatarsalgia, only relieve the symptoms, every 2-3 months trimming. (3) Foot pads. For most of the metatarsalgia, it is caused by the increased local stress on the bottom of the foot. The use of soft foot pads can cushion the local stress. Another type of foot pad is to prop up the proximal end of the metatarsal head, thus reducing the stress on the metatarsal head. (4) Wear hard, curved-soled shoes with soft insoles. This can reduce the stress on the forefoot during walking and alleviate the symptoms. (5) Hammertoe deformity, orthotics can be used to correct interphalangeal joint flexion and metatarsophalangeal joint dorsiflexion. To reduce the compression of the metatarsal head by the proximal phalanx. (6) Inflammation caused by tendon, joint capsule, ligament injury and synovitis of the joint can be treated with physical therapy and closure. (7) Use of non-steroidal anti-inflammatory and pain-relieving drugs. (8) Intermetatarsal neuroma can also be treated with hormone injections around the common toe nerve between the two metatarsal heads. (9) Wear forefoot load-free shoes for 2 months in case of fatigue fracture. 2.Surgical treatment If non-surgical treatment is not effective and the symptoms are heavy and affect life and work, surgical treatment can be considered. (1) For metatarsalgia caused by increased local stress, the most commonly used surgery is to osteotomize the corresponding metatarsal bone to lift the metatarsal head or shorten the metatarsal bone. For example, Weil osteotomy of the metatarsal head and neck. (2) For hammertoe, soft tissues around the metatarsophalangeal joint should be released, such as extension of the extensor tendon, lateral collateral ligament and metatarsal plate release. Flexion deformities of the interphalangeal joints may require plication, joint fusion, or artificial joint replacement. (3) Synovitis caused by damage to the cartilage of the metatarsal head can be cleared of synovial membrane and broken cartilage. Severe deformation of the metatarsal head requires removal of the metatarsal head and artificial joint replacement. (4) For intermetatarsal neuroma, the common toe nerve can be released or removed. (5) In severe rheumatoid arthritis, the forefoot often has significant metatarsalgia and often requires forefoot reconstruction surgery. The first metatarsal phalangeal joint fusion or joint replacement, 2-5 metatarsal head resection.