What is Freiberg’s disease?
Posted: Jul 18, 2021
The typical symptoms include increasing pain overlying the affected metatarsal head. There is typically a swelling and bruising surrounding the affected area. The pain will worsen with increase weightbearing activities. Usually there will be a decreased range of motion at the affected toe joint with pain present on movement of the affected toe. Limping to offloading the affected foot is also common. The diagnosis of Freiberg’s disease is made by a health care practitioner and is based on several features such as a full clinical assessment which will include a biomechanical assessment and gait analysis. There will be a review of the full pain history and medical history assessment to rule out any other causes for the symptoms. The joint range of motion will be assessed, and a physical palpation of the area will be done. The definitive diagnosis is usually done by x-ray and this typically shows a flattening to the metatarsal head, looking like a crushed egg shell in the most severe cases.
The treatment of Freiberg’s disease starts with rest and immobilisation of the area for up to six weeks. This is required in the early part of treatment for to allow the micro fracture site to heal. The immobilisation is often done with a moon boot or cam walker prescribed by a health practitioner. Foot orthotics may be used to reduce the painful symptoms of Freiberg’s disease. The aim of the foot orthotics is to achieve this by off loading the area and also with some re-aligning of the foot. They need to provide support to the painful area and are often used following that initial period of immobilization. A steel or carbon fibre plate can also often be used to make the shoe stiffer. This means that there is less flexion or bending of the shoe in the forefoot and this reduces stress on the area. Non steroidal anti-inflammatory medications such as ibuprofen may be given for pain relief and to reduce inflammation. If this does not help then a surgical repair of the fracture site may be required to repair the damage.
Craig Payne is a University lecturer, runner, cynic, researcher, skeptic, forum admin, woo basher, clinician, rabble-rouser, blogger and a dad.