What is Freiberg’s Disease?
Freiberg’s disease is a rare foot condition characterized by ischemic necrosis (bone death due to poor blood supply) of the metatarsal head, most commonly affecting the second or third metatarsal. This leads to joint pain, swelling, and stiffness, often making walking uncomfortable.
Symptoms of Freiberg’s Disease
- Pain and tenderness in the affected metatarsophalangeal (MTP) joint
- Swelling and stiffness, worsening with activity
- Difficulty walking or bearing weight on the foot
- In advanced cases, joint deformity due to bone collapse
Causes & Risk Factors
Freiberg’s disease is caused by disrupted blood flow to the metatarsal head, leading to osteonecrosis (bone death). Contributing factors include:
- Repetitive stress or trauma (common in athletes and dancers)
- Foot deformities (e.g., long second metatarsal)
- Poor footwear (tight or unsupportive shoes)
- Hormonal or vascular conditions affecting blood supply
Treatment Of Freiberg’s Disease
Non-Surgical Treatments
- Rest & Activity Modification – Avoiding high-impact activities to reduce stress on the joint.
- Orthotics & Supportive Footwear – Custom insoles to redistribute pressure.
- Pain Management – NSAIDs or corticosteroid injections for inflammation.
Surgical Treatments (for severe cases)
- Joint Reshaping Osteotomy – Realigning the bone to improve joint function.
- Proximal Phalangeal Head Excision – Removal of damaged bone in advanced arthritis.
- Joint Fusion (Arthrodesis) – Stabilizing the joint in chronic cases.
⚠️ Important Note: Never remove the entire metatarsal head, as this can lead to further foot instability and complications.
Recovery & Prevention
Early diagnosis improves outcomes. If left untreated, Freiberg’s disease can lead to permanent joint damage. Preventive measures include:
- Wearing properly fitted, cushioned footwear
- Avoiding excessive high-impact activities
- Using metatarsal pads to reduce pressure
Best Shoes For Freiberg’s Disease :
Recommended Shoe Types:
- Orthopedic Shoes (e.g., Dansko, Drew, Hoka Bondi, Brooks Ghost)
- Running Shoes with Metatarsal Support (e.g., ASICS Gel-Nimbus, New Balance 990v5)
- Rocker Bottom Shoes (e.g., Hoka Arahi, Altra Paradigm)
- Custom Orthotics – A podiatrist may prescribe metatarsal pads or a Morton’s extension to offload pressure.
Avoid:
- High heels
- Tight, narrow shoes
- Flat, unsupportive shoes (like ballet flats or flip-flops)
- Shoes with excessive toe spring
Read more about Orthopaedics Cases
Read More:
Freiberg’s Infraction: Diagnosis & Management – NIH
Surgical Options for Freiberg’s Disease
(Look for studies on surgical vs. conservative management.)
Mayo Clinic – Foot Pain Causes
(Search for “metatarsal pain” or “Freiberg’s” for symptoms and care tips.)
