Two patients walk into a podiatrist’s office. Both are active young women in their late teens or early twenties. Both have pain, swelling, and stiffness in the forefoot, near the base of the second toe. Both started feeling the pain after an extended period of increased activity, and find that the pain is worse when they’re running, dancing, or playing sports. So they have the same problem, right?
Not necessarily. Similar symptoms may come with very different diagnoses, which is why getting an expert evaluation is so important. One relatively rare foot condition—possibly experienced by one of our hypothetical patients above—we occasionally see is called Frieberg’s disease.
Frieberg’s Disease—Bone Breakdown in the Toes
Frieberg’s disease, first described in 1914, involves the gradual death and collapse of bone tissue at the head of a metatarsal bone due to a loss of blood supply, typically the second metatarsal (that’s roughly the base of your second toe). If not treated, the disease progresses through multiple stages, starting with microscopic fractures in the bones and following with flattening and collapse of the affected bones and joints.
The condition most frequently appears in younger athletes, particularly women, who engage in jumping or sprinting activities (running, dancing, basketball, etc.). A longer-than-usual metatarsal bone is also a common precipitating factor. The stress of repeated impacts can cut off the blood supply at the metatarsal head, slowly killing surrounding bone tissue.
Symptoms and Complications
In the early stages symptoms may be mild or even non-existent, but as the disease progresses through stages you may notice increased pain (especially during activity), deformity, and onset of arthritis. Left untreated and allowed some damage may become permanent in the later stages.
Pursuing Treatment That Works
The good news is that, if diagnosed in the early stages, conservative treatments are often sufficient for a full recovery. Simple approaches such as rest, shoe modifications, and metatarsal pads could well be enough to deal with the problem, though you will have to follow instructions from your doctor carefully. You may need to discontinue your previous activities for a period of 4-6 weeks.
If conservative treatments are insufficient, a surgical procedure will need to be selected based on the severity of the condition. These may include resection, remodeling, debridement, or even a metatarsal head replacement, depending on your needs.
Obviously, though, the goal is to deal with the problem early so that surgery can be avoided entirely. That’s why it’s critical that you visit Dr. Keith McSpadden when you first notices signs of pain, swelling, or stiffness in your toes. Although it may or may not ultimately be Frieberg’s disease, it’s important to take action quickly for any type of foot pain so that you can get a proper diagnosis, heal fully and quickly, and avoid potential complications.
To set an appointment at one of our two Greater Austin offices—Cedar Park or Round Rock—give us a call at 512-593-2949 today, or contact us online through this website. You can also keep up with our office regularly by reading our weekly blog entries and following us on Facebook, Twitter, Google, and Pinterest.