October 6, 2025 | Podiatry Help

Metatarsalgia is a ‘waste bucket’ term that means pain in the forefoot or metatarsal region. It could be any number of things such as sesamoiditis, plantar plate dysfunction or a mortons neuroma

Metatarsalgia is a general term that refers to pain and inflammation in the ball of the foot, specifically around the metatarsal heads—the bones just behind the toes. This condition often feels like a sharp, aching, or burning pain in the forefoot, especially during activities like walking, running, or even just standing for long periods. Many people describe it as feeling like there’s a pebble in their shoe or that they’re walking on a bruise. It typically develops over time due to repetitive stress rather than a single traumatic event.

There are a variety of causes and contributing factors for metatarsalgia. Improper footwear—like high heels or shoes with a narrow toe box—can concentrate pressure on the metatarsals. High-impact sports, foot deformities (like bunions or hammertoes), tight calf muscles, or having a high arch (pes cavus) can all shift weight abnormally to the forefoot. Additionally, carrying extra weight or experiencing age-related fat pad thinning under the metatarsals can make someone more prone to this condition. Sometimes, metatarsalgia occurs in tandem with other problems like Morton’s neuroma or stress fractures, complicating the diagnosis.

Treatment is usually conservative and focuses on offloading pressure and reducing inflammation. This includes wearing shoes with a wide toe box and cushioned soles, using metatarsal pads or custom orthotics to redistribute weight, and modifying activities to avoid prolonged standing or high-impact movements. Ice, NSAIDs (non-steroidal anti-inflammatory drugs), and stretching exercises—especially for the Achilles tendon and calf—can also help. In rare, persistent cases, surgical intervention may be considered to correct anatomical issues or relieve nerve compression. Early management is key to preventing chronic pain and long-term changes in gait.

Most Useful Resources:
Metatarsalgia (Podiatry Arena)
Metatarsalgia (PodiaPaedia)
Metatarsalgia (Foot Health Forum)
M is for Metatarsalgia (Podiatry ABC)
Metatarsalgia (Best Running Shoes)

Multiple sclerosis (MS) is a chronic, often unpredictable disease that affects the central nervous system (CNS)—which includes the brain, spinal cord, and optic nerves. It’s classified as an autoimmune disorder, meaning the body’s immune system mistakenly attacks its own tissues. In the case of MS, the immune system targets the myelin sheath, a protective layer that surrounds nerve fibers. This damage disrupts the normal flow of electrical signals in the CNS, leading to a wide variety of neurological symptoms. Depending on where the damage occurs, symptoms can include numbness, vision problems, muscle weakness, balance issues, fatigue, or even cognitive changes.

The course of MS can vary dramatically from person to person. There are a few main types: relapsing-remitting MS (RRMS) is the most common and involves clear flare-ups (relapses) followed by periods of recovery (remission). Others may experience secondary progressive MS (SPMS), where the disease gradually worsens over time, or primary progressive MS (PPMS), which is progressive from the start without distinct relapses. The exact cause of MS isn’t fully understood, but it’s thought to involve a mix of genetic predisposition and environmental triggers—like certain viruses (e.g., Epstein-Barr), low vitamin D levels, and possibly smoking. MS is more common in women and often starts between the ages of 20 and 40.

Treatment focuses on managing symptoms, modifying the disease course, and improving quality of life. Disease-modifying therapies (DMTs) are the cornerstone for many patients—they help reduce the frequency and severity of relapses and slow progression. These drugs include injectable medications, oral pills, and infusion-based therapies. Alongside that, physical therapy, lifestyle changes (like staying active and managing stress), and medications for specific symptoms (like spasticity or fatigue) all play a role. While there’s currently no cure, ongoing research in immunology, stem cells, and remyelination techniques is offering a lot of hope for better treatments—and maybe even a cure—in the future.

Most Useful Resources:
Multiple Sclerosis (Podiatry Arena)
Multiple Sclerosis (PodiaPaedia)
Multiple Sclerosis (Foot Health Forum)
Multiple Sclerosis Diagnosis & Management (Podiatry Apps)