Freiberg’s Disease

This is a rare condition, most commonly seen in teenage girls, and was first described in 1914 by Alfred H. Freiberg. Its onset is during the growth spurt at puberty, and is often linked to an injury to the growth plate of one of the long bones behind the toes, called metatarsals.

Freiberg’s Disease is usually associated with physical activity, and wearing high-heeled shoes makes it worse.

Typical symptoms include:

• Pain in the forefoot
• Localised swelling and stiffness in the big joint of the big toe
• A limp may be visible.

Treatment for Frieberg’s Disease usually consists of reducing pressure under the affected bone. This may require the use of crutches and/or prescription of a custom orthotic. In rare cases, a surgical procedure is required, but most patients are able to return to normal activity after treatment.

Treatment

The immediate goal of treatment is pain relief. Because symptoms generally worsen with activity, the main treatment is rest, which helps to relieve pressure on the heel bone, decreasing swelling and reducing pain.

A specialist may also recommend:

• Foot and leg exercises to stretch and strengthen the leg muscles and tendons
• The application of ice (wrapped in a towel, not applied directly to the skin) to the injured heel for 20 minutes two or three times per day.
• The use of an elastic wrap or compression stocking
• Medicines such as ibuprofen

In very severe cases, the doctor might recommend that the child wear a cast for anywhere from 2 to 12 weeks to immobilise the foot so that it can heal.