Pain in the ball of the foot is a common problem and can be due to many different conditions. Often the term, metatarsalgia is used for this problem but that term is so meaningless it is like saying that you have a sore knee. The pain that gets lumped under this term could range from a simple callus of the skin under the ball of the foot to a stress fracture of the metatarsal bone to a pinched nerve to an arthritis type problem. All of these conditions are very different to each other and each of them will need to be treated differently and have different outcome. From this it should be obvious why the term metatarsalgia is not a very good term, just like saying the knee is sore.
Diagnosing the different causes of pain in the ball of the foot can be a challenge as a number of the conditions might have similar symptoms in the early stages. That is why a skilled clinician is often needed to get the diagnosis right so the right treatment can be directed at it and time and money or not lost pursing the wrong diagnosis. Some conditions like a plantar plate tear which is a common reason for pain in the ball of the foot have a number of clinical tests that can be done to help determine if that is the problem. Others like a stress fracture of the bone is going to need and x-ray to get the diagnosis right. Arthritis like conditions are hard to diagnoses in the early stages and it can be a case of just waiting to see how the conditions progresses. Often diagnosing those type of conditions is a matter of ruling out the other conditions like a plantar plate tear or stress fracture by the clinical tests and x-ray. If you have pain in the ball of the foot, then get to a competent podiatrist and get the diagnosis right.