Freiberg’s Disease: Causes, Symptoms, and Treatment Options

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 Options

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

Freiberg’s disease

Freiberg’s disease

Freiberg’s disease

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