Freiberg’s disease is a health condition associated with pain in your forefoot. The problem occurs when one or more of the metatarsal heads in your feet softens, which can lead to a range of issues in your foot. Today, we take a closer look at Freiberg’s disease, how it is diagnosed and how it is treated.
Causes and Symptoms of Freiberg’s Disease
Freiberg’s disease is most often caused by repetitive microtrauma to the metatarsals in your foot. Doctors also believe that genetics play a role in the onset of the condition. Freiberg’s disease is most commonly seen in young, active athletes who are still growing and putting a lot of pressure on their feet. Oftentimes it is seen in dancers, runners and high school athletes.
Symptoms of Freiberg’s disease include:
- Pain in the front of the foot
- Pain when walking or running or “pushing off”
- Swelling
- Localized discomfort
- Inhibited gait or limping
- Inhibited range of motion in the foot
Diagnosis and Treatment of Freiberg’s Disease
Like most conditions, Freiberg’s disease is best diagnosed by an assessment performed by a trained orthopedic specialist. Your doctor will begin by looking the the toe joints and examining for tenderness, pain and swelling. If they believe Freiberg’s disease is a possibility, they will confirm their suspicions with an imaging exam. An x-ray is the most common test, as it allows a doctor to look for a change in the shape of the metatarsal head. An MRI may also be ordered, but most situations only call for an X-ray.
The good thing about Freiberg’s disease is that it is relatively easy to treat. The vast majority of cases are treated successfully with non-operative methods. Your doctor will first recommend that you switch to a comfortable shoe that has a soft rubber sole, plenty of cushioning and a wide toe box. A metatarsal pad insert can also help take stress off the area. Doctors may also recommend anti-inflammatory medications or over-the-counter pain relievers to help prevent discomfort while the metatarsal is healing.
A more severe case may require a walking boot or a cast to help offload the foot, but these are usually only used for two weeks. The metatarsal head usually re-vascularizes during this time, and symptoms will lessen or disappear as this process occurs.
In rare cases, surgery may be needed to fully address the problem. A surgical procedure typically involves a debridement of the metatarsal joint. The metatarsal head may be reshaped and a synovectomy may be performed, but as we noted above, surgery is rarely needed.