Freiberg's Disease


Overview

Freiberg’s Disease is a form of avascular necrosis in the metatarsal bones of the foot. It can develop in any metatarsal head but usually occurs in the second.  Avascular necrosis is an interruption of blood supply to the bone resulting in the death of the boney tissue.

Condition

The medical term for this condition is osteochondrosis.  It effects the metatarsal bones that partially make up the forefoot of the foot. It is most commonly identified in the 2nd metatarsal and most often found in females aged 13-15.

Symptoms & Signs

The effected forefoot region can become painful with weight-bearing activities especially at the push off phase of walking or running. Pain can usually be localized to the effected bone vs the whole forefoot or toes.

Treatment

The goal is to reduce pressure to the effected bony region. This includes proper shoe fitting to reduce side compression. A metatarsal pad on a custom or non-custom orthotic can reduce pressure from the ground. Activity modification / reduction may be required.

Symptoms & Cause

The effected foot can become painful on both the top and bottom aspect. Palpation of the specific bone can increase localized pain. There may be localized swelling and thickening about the bone with limited range of motion.

  • Pain in the forefoot, usually localized to the head of the second metatarsal.
  • Usually this is associated with physical activity.
  • Wearing high-heeled shoes makes it worse.
  • A limp may be visible with walking.
Pedorthic Treatment

Treatment for Freiberg’s Disease is to offload the affected metatarsal head.  There are many ways to accomplish this and may include the following:

  • Ensuring proper footwear fit and usage during all weight bearing activities is important.  There should be extra forefoot width and height to prevent pressure to the affected area.
  • In cases where a structural issue or biomechanical abnormality is identified, custom foot orthotics with metatarsal unloading and cushioning can be designed and fitted.
  • Shoe modifications such as metatarsal pads, rocker soles or excavations.

If you are experiencing foot pain or discomfort, you should consult your physician for a proper diagnosis and an appropriate treatment plan.

 

Your doctor may refer you to OKAPED to see a Canadian Certified Pedorthist for Pedorthic management of your foot pain. This may include orthopaedic footwear, shoe selection guidance, orthotics and/or foot related products such as a metatarsal pad. If you know your condition and want to learn about new products and treatments please give us a call.

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