There are many different causes to get problems inside the ball of the feet. A more uncommon reason is a problem called Freiberg’s disease or infarction. It is a problem in which the head of a metatarsal bone which is at the base of the toes in the ball of the foot gets weaker and has minuscule bone injuries. It most often affects the 2nd and 3rd metatarsal heads, though all metatarsal heads may be affected. It is thought to be caused by repeated overload to the metatarsals heads which create a localised lack of blood circulation to the bone. These metatarsal heads then become less strong and collapses. Freiberg’s disease principally occurs in younger sports athletes over about the age of 12, and more commonly affects younger females more than young boys. The actual micro fractures seems to originate from overloads and particularly in sporting activities which involve a lot of sprints, jumping or bearing weight on the front foot. Wearing non supportive or non-cushioning footwear could give rise to higher stress upon the metatarsal bones.
The typical features of Freibergs disease include things like increasing pain and discomfort overlying the impacted metatarsal bone. There is typically a swelling and bruising surrounding the affected area. The discomfort might become worse with increased weight bearing tasks. Commonly it will have a decreased ability to move at the damaged toe joint with discomfort present with movement with the damaged toe. Having a limp to to relieve the pain in the damaged area is also common. Detecting Freiberg’s disease is done by a medical practitioner and it is determined by a number of characteristics like a full clinical review which can incorporate a biomechanical examination as well as a walking investigation. There will be a review of the complete pain and discomfort background and medical history evaluation to rule out any other reasons for the symptoms. The joint range of motion is going to be looked at, along with a thorough palpation of the bone will be completed. The conclusive diagnosis is usually made by x-ray which frequently shows a flattening towards the metatarsal head, giving the impression of a crushed egg shell within the more extreme cases.
The treatment of Freibergs disease starts off with rest along with immobilisation of the area for as much as six weeks. This can be necessary in the first part of treatment for to permit the minuscule fracture site to recover. The immobilisation is often carried out with a moon boot or cam brace prescribed by a health practitioner. Foot orthotics might be used to decrease the painful signs and symptoms of Freiberg’s disease. The aim of the foot orthotics would be to achieve this by lowering weight bearing in the metatarsal head and in addition with some re-aligning of the foot. They must offer support for the painful area and so are often advised following that early period of immobilization. A metal or even graphite insole also can regularly utilized to make the footwear stiffer. Because of this there's much less flexion or bending of the shoe with the forefoot which decreases force on the metatarsal head. Non steroidal anti-inflammatory drugs such as ibuprofen can be offered for pain relief as well as lower inflammation. If this fails to help then a surgical fix of the micro-fracture site are usually necessary to fix the pain.