When the metatarsal region, commonly known as the ball of the foot, becomes inflamed or is painful, it’s referred to metatarsalgia or stone bruise. Affecting the metatarsal joints and bones, this condition is characterized by sharp or burning pain that worsens with activity. Other symptoms include shooting pain, numbness, and tingling as well as a feeling that a pebble is in your shoe. Causes of metatarsalgia include intense activity, such as running and high-impact sports; high arches and/or longer second toes; foot deformities, such as hammertoe; poorly fitting shoes like high heels; stress fractures; noncancerous growth of fibrous tissue in the metatarsal region (also known as Morton’s neuroma); and pressure from excess body weight. Initial treatment includes rest, ice, compression, and elevation. If pain persists for several days, seek medical attention. Diagnosing metatarsalgia may involve x-ray to determine whether there’s a fracture. In serious cases, particularly ones involving foot deformities, surgery may be necessary to realign metatarsal bones. Physical therapy can play a role in treating metatarsalgia either as an alternative to surgery or following an operation. Typically, physical therapy will involve exercises, stretches, massage, and footwear consultation. Furthermore, arch supports, metatarsal pads, proper footwear, and shock-absorbing insoles all may help to ease the pain associated with metatarsalgia.