Freiberg's disease (Avascular necrosis in metatarsal)

Freiberg's disease is a form of avascular necrosis that affects the metatarsals (the five legs in the forefoot). Freiberg's disease normally affects the second (2nd) metatarsal bone, but can in theory affect any of the five metatarsal bones. The pain can be quite constant in the affected area, even at rest, but worse at weight bearing. Numbness and throbbing pain may also occur in the area.

Causes of Freiberg's disease

Repetitive physical exertion over time can cause microfractures where the center of the metatarsal bones attaches to the growth plate. Due to the microfractures in the middle of the metatarsals, the end of the bone will not receive the blood circulation it needs - which causes necrosis (death of cells and tissues) due to lack of oxygen and nutrients.

Who is affected by Freiberg's disease?

The condition is very rare, but most often affects younger women, athletes and those with extra long metatarsals. 80% of those who receive the diagnosis are women.

- Here we see the anatomy of the foot, and we see how the metatarsal is the legs before the toes.

Symptoms of Freiberg's disease

Usually, patients will have experienced the ailment after activity that has involved a shock load against the forefoot, e.g. jogging. Patients can go with pain in the forefoot for months and years before seeking help for it, while others get it more acute after an injury or the like. The pain can be vague and is often difficult to locate - it is often described as if it feels like a small object is stuck inside the foot.

Diagnosis of Freiberg's disease

A clinical examination will show impaired movement and local tenderness over the affected metatarsal bone on palpation. In earlier stages, only local tenderness may be the only thing found, but persistent ailments will also be able to cause crepitus (sound in the joint when you move it) and bone formation. Other possible causes of similar symptoms are capsulitis, stress fracture, intermetatarsal bursitis or Morton's neuroma.

Imaging study of Freiberg's disease (X-ray, MRI, CT or ultrasound)

First, an X-ray will be taken, but the weakness of this is that it may not show Freiberg's at an early stage. One MRI examination is the most useful tool when it comes to detecting Freiberg's early. 3D CT examination can give a good picture of how extensive the damage from the necrosis is.

X-ray of Freiberg's disease:

- In the picture above we see osteonecrosis (death of bone tissue) in the second metatarsal. A characteristic sign of Freiberg's disease.

Treatment of Freiberg's disease

The main purpose of treating Freiberg's disease is to allow the area to heal itself and thus reduce both pain and inflammation. A rest period of 4-6 weeks without strain is recommended in most cases. Some may need crutches, while others may need shock-absorbing soles, gel pads and shoes - it varies. Anti-inflammatory drugs (eg Ibux) are not recommended, as this may take longer for the injury to heal. Cold treatment can provide pain relief for sore joints and muscles, also in the foot. Blue. Biofreeze is a popular product. One should always try conservative treatment for a long time before resorting to invasive procedures (surgery and surgery), but in some cases this is the only way out.

What can I do even for muscle and joint pain?

1. General exercise, specific exercise, stretching and activity are recommended, but stay within the pain limit. Two walks a day of 20-40 minutes make good for the whole body and sore muscles.

2. Trigger point / massage balls we strongly recommend - they come in different sizes so you can hit well even on all parts of the body. There is no better self help than this! We recommend the following (click the image below) - which is a complete set of 5 trigger point / massage balls in different sizes:

3. Training: Specific training with training tricks of various opponents (such as this complete set of 6 knits of different resistance) can help you train strength and function. Knit training often involves more specific training, which in turn can lead to more effective injury prevention and pain reduction.

4. Pain Relief - Cooling: Biofreeze is a natural product that can relieve pain by cooling the area gently. Cooling is especially recommended when the pain is very severe. When they have calmed down then heat treatment is recommended - it is therefore advisable to have both cooling and heating available.

5. Pain Relief - Heating: Warming up tight muscles can increase blood circulation and reduce pain. We recommend the following reusable hot / cold gasket (click here to read more about it) - which can be used both for cooling (can be frozen) and for heating (can be heated in the microwave).

Recommended products for pain relief for muscle and joint pain

Biofreeze (Cold / cryotherapy)

Exercises for Freiberg's disease

One should try to cut out too much weight-bearing exercise if one is affected by Freiberg's disease. Replace jogging with swimming, elliptical machine or exercise bike. Also, make sure that you stretch your foot and train your feet lightly as shown this article.

Related article: - 4 good exercises for sore feet!

Further reading: - Sore foot? You should know this!

Also read:

- Pressure wave treatment of plantar fascite

- Exercises and stretching of plantar fascia heel pain

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Training:

• Cross-trainer / ellipse machine: Excellent fitness training. Good for promoting movement in the body and exercising overall.
• Rowing Machines is one of the best forms of training you can use to get good overall strength.
• Spinning ergometer bike: Good to have at home, so you can increase the amount of exercise throughout the year and get better fitness.

Sources:
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Frequently asked questions regarding Freiberg's disease:

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