Foot Mysteries: Causes of Freiberg's Disease

Robert G. Parker
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Dr. Parker is a podiatrist and surgeon in Houston, TX who has been helping patients for more than 40 years.

For anyone fascinated by outer space, there’s no place better than Houston. The Space Center Houston, a NASA museum, expands the universe as it teaches visitors about space and NASA itself. Take a day to wander the expansive facility, enjoy a unique exhibit, or even explore an educational program there. Unfortunately, discovering the mysteries of space doesn’t help with the mysteries of foot pain. Some problems, like the causes of Freiberg’s disease, continue to be mysterious.

Freiberg’s disease is a rare bone problem that usually affects children and teenagers, particularly girls. One of the metatarsal heads—usually the second digit—breaks down and flattens out under pressure. This causes progressively worsening ball of the foot pain. Your forefoot swells somewhat and becomes tender to the touch. Activities and certain shoes typically make the discomfort worse. You may even develop a limp if the problem deteriorates enough.

No one knows the specific causes of Freiberg’s disease. No single problem or pattern seems to explain the issue. Genetic predisposition may play a role, though not enough evidence has been found to determine that. Since it occurs most frequently in children and teenagers, it may be a disruption in the growth plate or the ends of bone in still-growing feet. However, this doesn’t explain why adults can develop the problem as well.

For some people, the problem is trauma-induced. A harsh injury damages the affected metatarsal, and continued pressure on the weakened bone causes its head to collapse. Repetitive pressure over enough time—like constantly wearing high heels—could potentially injure the bone enough to flatten it as well. Another potential contributor is vascular insufficiency. Weak or impaired blood supply may allow the metatarsal to deteriorate and break down. The current thought is that a combination of factors leads to Freiberg’s disease over time.

Not knowing the exact cause doesn’t mean the problem can’t be remedied or prevented from reoccurring. Let our team at Parker Foot & Ankle help you heal your metatarsals and eliminate your limp. Call our Houston office at (281) 497-2850 or use our website to make an appointment with us.

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