About the condition
What is Freiberg's Infarction? Freiberg's infarction, also known as Freiberg's disease, is a condition that affects the metatarsal bones in the foot, most commonly the second metatarsal head. It occurs when the blood supply to the metatarsal head is disrupted, leading to bone death (osteonecrosis) and subsequent joint damage.
Symptoms
• Pain and swelling in the forefoot, especially around the second metatarsal head.
• Stiffness and limited range of motion in the affected toe.
• Tenderness and discomfort when walking or bearing weight on the foot.
• Pain at night waking sufferers from sleep
Causes
• Repetitive stress or trauma to the metatarsal head.
• Poor blood supply to the metatarsal bone.
• Foot deformities and biomechanics like an unusually long metatarsal, sagittal plane blockade
• Wearing improper footwear.
• Age, most common when bones are still growing
• Sports, like ballet can contribute
Diagnosis A podiatrist will diagnose Freiberg's infarction based on your medical history and a physical examination of your foot. Imaging tests such as X-rays, MRI, or CT scans may be used to assess the severity of the condition and rule out other causes of foot pain.
Acute Condition In the acute phase, Freiberg's infarction presents with sudden onset of pain and swelling in the forefoot. The affected area may be tender to touch, and there may be difficulty in bearing weight on the foot. Early diagnosis and treatment are crucial to prevent further joint damage.
Chronic Condition In the chronic phase, Freiberg's infarction may lead to persistent pain, stiffness, and deformity in the affected toe. The joint may become arthritic, and there may be a noticeable change in the shape of the toe. Long-term management focuses on alleviating symptoms and maintaining foot function.
Treatment
• Rest: Avoid activities that put stress on the affected foot.
• Symptom management: Apply ice, using analgesics and/or ibuprofen, massage, stretches and night splints can help manage short term symptoms
• Fracture boot: often given initially in A&E but can be bought online cheaply in the acute stage.
• Footwear: Wear supportive shoes with good longitudinal support and cushioning under the ball of foot. HOKAs are ideal
• Orthotics: Use custom orthotic devices to support your feet and reduce pressure on the metatarsal head.
• Injections: Corticosteroid injections may be used to reduce inflammation.
• Surgery: In severe cases, surgery may be necessary to remove the damaged bone or repair the joint.
Prevention
• Wear supportive footwear with a wide toe box.
• Avoid high-heeled shoes.
• Take breaks and rest your feet during activities that put pressure on them.
• Maintain a healthy weight.
• Manage activity during childhood growth spurts.
