There are lots of causes to get pain within the ball of the feet. A more uncommon cause is a disorder known as Freiberg’s disease or infarction. This is a condition where the end of a metatarsal bone that is at the base of the toes within the front foot results in being weaker and has small fractures. Freiberg’s disease most commonly affects the 2nd and 3rd metatarsal bones, though they all can be impacted. It is considered to be because of repeated overload on the metatarsals bone that create a localised lack of blood flow to the bone. The metatarsal heads then come to be less strong and has micro fractures. Freiberg’s disease generally occurs in young sports athletes above approximately the age of 12, and much more frequently impacts younger females a lot more than younger males. The actual micro trauma appears to come from overloads especially in sporting activities which entail a considerable amount of sprinting, leaping or weight bearing over the ball of the foot. Using non supportive or non-cushioning shoes might contribute to underlying force upon the metatarsal bones.
The common signs and symptoms include increasing discomfort around the affected metatarsal bone. There is generally a inflammation and slight discoloration surrounding the metatarsal head. The discomfort will get worse with increased weight bearing actions. Usually you will have a decreased range of flexibility with the damaged toe joint with pain and discomfort present on movement in the affected toe joint. Having a limp to get weight off the damaged foot is furthermore prevalent. The diagnosis of Freiberg’s disease is made by a medical practitioner and it is based upon many features like a complete clinical evaluation which should include a structural examination and also a gait evaluation. You will have a review of the full pain and discomfort background and medical history analysis to eliminate virtually any other causes for the symptoms. The joint range of flexion will be assessed, and a thorough palpation of the area will be completed. The conclusive diagnosis will likely be completed by x-ray and this characteristically shows a flattening to the metatarsal bone, resembling a smashed egg shell with the more severe instances.
The management of Freiberg’s disease starts with rest as well as immobilisation with the area for around 6 weeks. This really is necessary in the initial period of therapy for allowing the micro fracture site to heal. The immobilisation is frequently carried out with a moon boot or perhaps cam walker suggested by a health practitioner. Foot orthoses may well be employed to minimize the painful signs and symptoms of Freiberg’s disease. The purpose of the foot insoles would be to accomplish this by lessening load bearing on the metatarsal head and in addition with some posture change with the feet. They should give support for the uncomfortable area and so are often used after that first duration of immobilization. A steel or perhaps carbon fibre insole also can regularly used to make the shoe stiffer. This means that there’s reduced flexion or bending of the shoe in the forefoot and this also lowers load on the metatarsal head. Non steroidal anti-inflammatory drugs like ibuprofen could be offered to decrease your pain as well as lessen inflammation. When this is not going to help then a surgical restoration of the micro-fracture site may be needed to solve the injury.