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Experiencing a Freiberg's infraction means that there is an interruption in the blood supply to the end of one of the long bones
(metatarsals) in the foot.
The symptoms of a Freiberg’s infraction may include feeling pain at a specific area of the ball of the foot that tends to worsen over the course of many weeks. Most often, it is the second or third metatarsals that are affected. As the pain worsens, we see many people adapt a limping gait in order to help reduce pain as they walk. Wearing heeled shoes may become too painful, and the affected joint may become stiff or swollen.
Freiberg’s infractions are thought to develop either from damage to the vascular supply to the metatarsal bone, or from trauma to the bone, which can occur from one large traumatic event (like jumping down from a high surface) or repetitive microtrauma over time (like running). Both of these can lead to damage to the bone and joint, interfering with the structural integrity in the area, and disrupting the blood supply. Anatomical features like having a long second metatarsal bone may also play a role.
The risk factors associated with developing a Freiberg’s infarction include age (more common in adolescents and young adults), being female, having specific foot structures (e.g., high arch or shorter second metatarsal bone), engaging in repetitive stress activities, having a history of foot injuries, a family history of the condition, having certain medical conditions (e.g., systemic lupus erythematosus), and wearing ill-fitting or high-heeled shoes.
Diagnosing a Freiberg's infarction begins with a thorough medical history and physical examination, focusing on the location and nature of the pain, the range of motion in the joints of the feet, a gait assessment and more. X-ray imaging may be used to identify changes in the affected metatarsal bone and joint, revealing any bone density changes or bone damage, particularly to the metatarsal head.
In some cases, an MRI may be recommended to obtain more detailed images of the foot, and a bone scan can help differentiate Freiberg's infarction from other causes of foot pain. As Freiberg’s can become serious if left untreated, it’s always important to get a formal diagnosis so that the best management and treatment plan can be started, helping you best manage your symptoms and prevent complications.
Treating a Freiberg’s infarction focuses on reducing or eliminating your painful symptoms, enabling you to continue to walk and remain mobile comfortably and normally, and helping reduce the impact on the end of the metatarsal so adequate blood flow can be maintained. In order to achieve this, we may use:
In severe cases, where sufficient symptom relief or progress cannot be achieved with conservative (non-invasive) measures, corticosteroid injections as well as discussions around the possibility of surgeries including joint debridement, bone reshaping, or joint realignment may be discussed.
Ignoring Freiberg's infarction symptoms can lead to the progression of the condition and potential complications. As the infarction worsens, the affected metatarsal bone can become more damaged, leading to joint deformities, chronic pain, and limited mobility. Without timely intervention, the condition may result in long-term joint damage, arthritis, and difficulties in walking or bearing weight on the affected foot.
While it may not be entirely preventable, you can reduce the risk of developing a Freiberg's infarction by:
It’s always best to see a podiatrist or a foot and ankle specialist if you experience persistent pain in the ball of your foot that worsens over time, especially if you notice difficulty walking or swelling in the affected area. Generally, we recommend seeing a podiatrist any time you begin to experience foot, ankle or leg pain.
The best way to prepare for your appointment with your podiatrist is by being able to recall information about your foot pain such as when it started, its severity, and the symptoms that you’re experiencing. If you’ve had any medical imaging or reports, please bring these along to your appointment. Don’t forget to bring your regular shoes (ideally both casual and exercise shoes) as well as any orthotics that you regularly wear.
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Ground Floor, 344 Queen Street,
Brisbane City QLD 4000
Monday | 7:40am - 6:00pm |
Tuesday | 7:40am - 6:00pm |
Wednesday | 7:40am - 6:00pm |
Thursday |
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Sunday | CLOSED |
Newmarket Village, 114/400 Newmarket Rd, Newmarket QLD 4051