In a developing human body, there are sections of bones that are known as growth plates. Your metatarsal bones, the long ones that run along your foot and connect with your toes at the metatarsophalangeal joint (MTPJ), have these particular plates. Freiberg’s disease happens when a series of microfractures, sometimes as a result of repetitive stress, develop in the plate and disrupt the circulation in the bone. Loss of blood flow leads to a condition known as avascular necrosis (cellular death) in the head of the bone. That might sound awful, but this disease is often successfully treated.
As noted, this condition may be onset by repetitive stress, but the actual cause remains a bit of a mystery. In many cases, the second toe is longer than the first, which results in a situation where that second toe has to take on more weight and pressure than it is intended to. This leads to problems in the MTPJ, including a potential onset of Freiberg’s. For whatever reason, this disease tends to be more commonly found in adolescent females than in males.
Symptoms for the condition include vague and poorly localized pain in the patient’s forefoot. Others include stiffness in the joint and a limp that results from the breakdown in bone tissue that happens at the metatarsal head of the second toe. Chronic forefoot pain, particularly after a specific injury or following excessive use, can be exhibited for many years as a result of the ailment.
We treat a wide range of common foot and ankle ailments at Achilles Foot and Ankle Specialists, but there are rare cases that also require our expert treatment. When you develop a condition that falls outside the normal scope of injuries and diseases, it is important to understand your symptoms and know when it is time to see our podiatrists. An example of this is Freiberg’s disease. We do not see it particularly often, but it does happen and is best treated as early as possible.
The primary form of treatment for this condition entails the use of conservative, nonsurgical methods that have the goals of immobilizing and providing rest to the affected joint. This allows mechanical inflammation and irritation to decrease and provides pain relief and comfort for our patient. We may prescribe or recommend medication that will help subside the pain and inflammation that accompanies the disease. When this course is taken, the intent is for swelling and inflammation to decrease, not for regular activity to resume. Some people think that, since they are not feeling the pain and discomfort, it is okay to go back to being active. At this point, though, rest is an important part of the healing process.
In addition to providing rest for the affected joint, we require out patients to restrict its range of motion. This is often achieved with the use of non-weight-bearing casts, shoe inserts or orthotics, and hard-sole shoes. All of these have proven to be effective in helping decrease the movement of the joint so that healing processes can proceed. When non-weight-bearing casts are used, they are able to keep pain and swelling levels down and decrease the risk of aggravation in the area.
Conservative treatment methods are often successful in the cases we see, but there are rare instances when a severe case may require a surgical procedure. Some of the potential options for this include resurfacing a bone to restore functionality in the joint (arthroplasty), cutting bone tissue to redirect the joint from the damaged region, simple debridement, or bone grafting.
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Living with the pain that comes from Freiberg’s is no fun. Fortunately, the leading podiatry team at Achilles Foot and Ankle are able to help you or your loved one overcome this condition. We offer world-class care for our patients in Richmond and the surrounding Virginia areas and look forward to helping take away your pain. Call our office at (804) 273-1717 or use our online form to schedule an appointment today.