There are many different reasons for discomfort inside the ball of the feet. A more uncommon cause is a disorder called Freiberg’s disease or infarction. It is a problem where the head of a metatarsal bone that's near the base of the toes within the ball of the foot becomes weakened and it has small cracks. Freiberg’s disease normally occurs in the 2nd and 3rd metatarsal heads, although all metatarsal heads might be impacted. It is believed to be the result of recurrent microtrauma to the metatarsals bone that create a local lack of blood flow to the region. These metatarsal heads next become less strong and has micro fractures. Freiberg’s disease typically happens in young athletes over approximately the ages of 12, and a lot more typically affects young females more than young boys. The actual micro trauma appears to originate from overloads especially in sports that involve a lot of sprinting, bouncing or bearing weight over the ball of the foot. Using non supportive or non-cushioning shoes could give rise to higher loads over the metatarsal heads.
The usual features include things like increasing pain over the affected metatarsal bone. There is usually a inflammation and bruising all around the affected region. The pain sensation might become worse with an increase in weight bearing activities. Typically it will have a reduced range of flexibility in the damaged toe joint together with discomfort found on movement with the damaged toe. Having a limp to offloading the affected foot is also frequent. Detecting Freibergs disease is made by a medical practitioner and it is based on several characteristics like a complete clinical review which will incorporate a biomechanical evaluation and also a gait examination. There will be a review of the full pain and discomfort history and health background evaluation to rule out any kind of other reasons for the symptoms. The joint range of flexion will be looked at, and a physical palpation of the bone will be done. The ideal diagnosis is generally performed by x-ray which generally shows a flattening with the metatarsal bone, resembling a crushed egg shell within the most extreme instances.
The management of Freibergs disease starts off with rest and immobilisation of the area for up to 6 weeks. This can be required in the initial period of therapy for to allow for the micro fracture area to get better. The immobilisation is often done with a moon boot or cam walker recommended by a health professional. Foot supports will be utilized to lessen the painful signs and symptoms of Freiberg’s disease. The purpose of the foot orthoses would be to achieve this by off loading the region and also with some re-aligning with the foot. They should be give support on the painful area and are frequently advised after that initial duration of immobilization. A steel or carbon fibre plate may also frequently helpful to make the footwear stiffer. This means that you will find reduced flexion or bending with the shoe in the front foot and this lowers load on the area. Non steroidal anti-inflammatory prescription drugs such as ibuprofen might be given for pain relief and to lessen inflammation. When this fails to help then a surgical restoration with the micro-fracture site may be required to solve the pain.
