Freiberg’s Disease is a condition that affects the second metatarsal head in the foot. This disease occurs when the blood supply to this area is disrupted, which leads to avascular necrosis, or the death of bone tissue due to a lack of blood. The exact cause of Freiberg’s Disease is not completely understood, but researchers believe that it may be related to mechanical stress on the foot. This stress can be linked to certain foot alignment issues, such as flat feet or high arches, that place extra pressure on the second metatarsal. Additionally, previous injuries or trauma to the foot can also increase the risk of developing this condition (Fukagawa et al., 2025).
Individuals with Freiberg’s Disease often report experiencing significant pain in the area of the affected metatarsal. This pain can be sharp or dull, and it usually worsens with activities such as walking or running. Alongside pain, patients may also experience stiffness in their toes and swelling around the metatarsal area. These symptoms can lead to difficulties in mobility, making it challenging for those affected to perform everyday tasks like walking, standing for long periods, or engaging in sports (Lee et al., 2016).
To diagnose Freiberg’s Disease, medical professionals typically begin with a thorough clinical examination, asking about the patient’s symptoms and medical history. Diagnosis is supported by imaging tests, such as X-rays or MRI scans, which can reveal changes in the bone structure and confirm the presence of metatarsal degeneration (Talusan et al., 2014). Early diagnosis is crucial, as it can help in the selection of appropriate treatment options that can improve the patient’s mobility.
When it comes to treatment options for Freiberg’s Disease, there are various approaches, and the choice often depends on the severity of the condition. For mild cases, conservative treatments are usually recommended. These may include rest, ice therapy, and the use of orthotic devices to provide better support to the foot. Physical therapy may also be suggested to strengthen the surrounding muscles and improve flexibility. However, if symptoms persist and the disease progresses, surgical intervention may become necessary. Surgical options can range from bone reshaping procedures to arthroscopic treatments that help relieve pain and restore function (Yoshimura et al., 2024).
Studies show that arthroscopic surgery can offer promising outcomes for patients suffering from advanced Freiberg’s Disease. This type of surgery involves using small incisions and specialized instruments to treat the affected area, which often leads to quicker recovery times and improved mobility (Kim et al., 2024).
Overall, Freiberg’s Disease can have a significant impact on an individual’s mobility and quality of life. The pain and restrictions caused by the condition can limit the ability to participate in social and recreational activities, leading to frustration and decreased overall satisfaction with life. Maintaining awareness of the etiology, symptoms, and treatment options is vital in helping those affected to navigate their challenges effectively., Treatment options for Freiberg’s Disease vary based on how advanced the condition is. Some recent studies are looking at different surgical methods to treat the disease effectively, highlighting the ongoing search for the best solutions (Incesoy et al., 2025). One promising surgical technique is called dorsiflexion closing wedge osteotomy. This procedure aims to restore proper foot function, which is crucial for everyday activities (Kooner et al., 2023).
Another approach that has been researched involves the use of autografts for restoring the metatarsal head. Autografts are tissue grafts that come from the patient’s own body. By using a patient’s own tissue, doctors hope to promote better healing and lower the risk of complications (Okutan et al., 2020). This reflects the wide variety of surgical options available to treat Freiberg’s Disease.
It is important to note that each patient may require a different type of treatment based on their specific needs. Personalized treatment is necessary not only for physical issues but also for the emotional and psychological effects of living with Freiberg’s Disease (El-Amin et al., 2023). Pain is a common symptom of this condition, and it can lead to limitations in movement and daily activities. When people experience chronic pain, it can affect their mood and overall well-being, making it even more difficult to manage daily tasks.
Healthcare providers should take a well-rounded approach to treatment. This means focusing on both physical healing and emotional support. When patients are treated, their mobility can improve, and they may feel better both physically and emotionally. By addressing all aspects of Freiberg’s Disease, healthcare workers can better assist patients in enhancing not just their ability to move around, but also their quality of life.
Studies emphasize the importance of understanding how Freiberg’s Disease affects a person’s life outside of physical symptoms. The impact can stretch into emotional and social areas, where individuals might feel isolated or experience changes in their relationships due to their condition (Schade, 2015). When healthcare providers take this holistic view, they can help to improve patient outcomes substantially, leading to a more integrated way of coping with the challenges presented by Freiberg’s Disease.
As such, discussions about treatment should include how to manage pain, improve mobility, and offer psychological support. Healthcare systems should place value on not just easing the physical burdens but also ensuring that individuals with Freiberg’s Disease maintain their engagement with their personal and social lives. Focusing on these comprehensive treatment approaches can help promote a better quality of life for those affected by the condition.
Citations:
Talusan, P.G., Diaz-Collado, P.J. and Reach Jr, J.S., 2014. Freiberg’s infraction: diagnosis and treatment. Foot & Ankle Specialist, 7(1), pp.52-56. https://journals.sagepub.com/doi/abs/10.1177/1938640013510314
Yoshimura, I., Takao, M., Wagner, E., Stufkens, S., Dahmen, J., Kerkhoffs, G.M. and Glazebrook, M., 2024. Evidence-based treatment algorithm for Freiberg disease. Cartilage, 15(1), pp.58-64. https://journals.sagepub.com/doi/abs/10.1177/19476035231205676
Lee, D.Y., Lee, D.O. and Jung, H.G., 2016. Metatarsalgia and toe deformities. In Foot and Ankle Disorders: An Illustrated Reference (pp. 77-119). Berlin, Heidelberg: Springer Berlin Heidelberg. https://link.springer.com/chapter/10.1007/978-3-642-54493-4_3
Fukagawa, R., Yoshimura, I., Hagio, T., Ishimatsu, T., Sugino, Y., Tomonaga, S., Taniguchi, Y. and Yamamoto, T., 2025. Foot alignment characteristics in patients with Freiberg’s disease. Journal of Orthopaedic Science. https://www.sciencedirect.com/science/article/pii/S0949265825001897
Kim, J.K., Kim, D.Y., Oh, J.S., Ko, D.I. and Lee, K.B., 2024. Short-Term Outcomes of Arthroscopic Treatment of Freiberg Disease. Journal of the American Podiatric Medical Association, 114(3). https://japmaonline.org/view/journals/apms/114/3/22-025.xml
Incesoy, M.A., Pehlivanoglu, G., Kaya, H.B., Geckalan, M.A., Ozdemir, A.A., Yildiz, F. and Uzer, G., 2025. Comparative study of dorsiflexion closing wedge osteotomy of the metatarsal head and osteochondral autologous transplantation for Freiberg disease treatment: A multicenter analysis. The Journal of Foot and Ankle Surgery, 64(2), pp.113-119. https://www.sciencedirect.com/science/article/pii/S1067251624002229
Okutan, A.E., Ayas, M.S., Öner, K. and Turhan, A.U., 2020. Metatarsal head restoration with tendon autograft in Freiberg’s disease: a case report. The Journal of Foot and Ankle Surgery, 59(5), pp.1109-1112. https://www.sciencedirect.com/science/article/pii/S1067251620301629
El-Amin, H., Ali, A.M.A., Elmansour, O.K.O., Abbas, R., Mohamed, E., Biraima, W.H., Ahmed, O.K., Mohamedali, A.O., Arja, A., Babikir, A.O.A. and Elmansour Sr, O.K.O., 2023. Freiberg’s Disease Involving First Metatarsal Bone Bilaterally in an African Male Patient: A Case Report. Cureus, 15(11). https://www.cureus.com/articles/200061-freibergs-disease-involving-first-metatarsal-bone-bilaterally-in-an-african-male-patient-a-case-report.pdf
Kooner, S., Lee, J.M., Jamal, B., David-West, K., Daniels, T.R. and Halai, M., 2023. Successful treatment of advanced Freiberg’s disease with a modified Weil osteotomy, 5-year follow up: A Pilot case series with a review of the literature. The Foot, 57, p.101952. https://www.sciencedirect.com/science/article/pii/S0958259222000499
Schade, V.L., 2015. Surgical management of Freiberg’s infraction: a systematic review. Foot & Ankle Specialist, 8(6), pp.498-519. https://journals.sagepub.com/doi/abs/10.1177/1938640015585966
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