There are lots of reasons for pain in the ball of the feet. A more uncommon explanation is a problem known as Freiberg’s disease or infarction. It is a disorder in which the end of a metatarsal bone which is at the bottom of the toes in the ball of the foot will become less strong and it has minuscule fractures. Freiberg’s disease most often occurs in the 2nd and 3rd metatarsal heads, though they all might be impacted. It is believed to be the result of repeated microtrauma to the metatarsals heads that result in a local deficit of blood circulation to the bone. The metatarsal bones next become weakened and collapses. Freiberg’s disease mostly happens in younger sports athletes over about the ages of twelve, and a lot more commonly impacts younger females a lot more than younger males. The actual microtrauma appears to result from overloads and particularly in sporting activities which involve a considerable amount of sprints, jumping or weight bearing over the forefoot. Using non supporting or poorly cushioned footwear may possibly bring about underlying pressure over the metatarsal heads.
The typical symptoms include increasing pain over the impacted metatarsal head. There is often a swelling and slight discoloration about the involved area. The discomfort will worsen with elevated weight bearing actions. Frequently there will be a decreased range of flexibility at the impacted toe joint along with pain present with movement of the damaged toe. Limping to get weight off the affected foot is furthermore frequent. The diagnosis of Freiberg’s disease is done by a medical specialist and it is determined by many characteristics such as a complete clinical evaluation which can incorporate a structural assessment and also a gait analysis. You will have an overview of the full pain and discomfort background and health background analysis to rule out any kind of other reasons for the signs or symptoms. The joint range of motion is going to be looked at, along with a physical palpation of the bone will be performed. The definitive diagnosis will likely be done by x-ray which often demonstrates a flattening to the metatarsal head, resembling a crushed egg shell within the most serious cases.
The treating of Freibergs disease starts with rest and also immobilisation with the area for about six weeks. This is needed in the early period of treatment for it to allow the minuscule fracture in the bone to heal. The immobilisation is frequently finished with a moon boot or cam walker given by a physician. Foot supports may well be used to minimize the painful signs and symptoms of Freibergs disease. The objective of the foot orthoses would be to accomplish that through reducing the force for the metatarsal head and in addition with some posture change of the foot. They should offer support to the painful area and so are frequently advised following that early duration of immobilization. A steel or graphite insole also can often be helpful to make the shoe stiffer. Because of this there's much less flexion or bending of the footwear in the forefoot and this decreases force on the location. Non steroidal anti-inflammatory medications such as motrin might be offered for pain relief and to lower inflammation. If this is not going to improve then a surgical repair of the fracture site are usually necessary to repair the damaged tissues.