Freidberg's disease

AKA freidberg's Infarction

- rare second toe breakdown -

Although it’s rare, pain in the second toe can be caused by just that: an uncommon condition called Freiberg’s disease that allows the end of the metatarsal bone to wear down under stress.

Imagine you’re drawing with chalk on rough pavement. As you draw, the stick of chalk in your hand slowly wears down under the pressure and grinding.

Enough pressure over a period of time can wear down pretty much anything, including mountains, concrete, and the structures in your feet.

What if I think I have Freidberg's Diease?

Most likely you do not.  But if you do, or if you are having pain in that area, please give us a call and let one of our specialists help you.

Don’t allow yourself or those you love suffer in pain & discomfort!

Take the next step toward happy feet and schedule today!

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quick links:

xray image of how high heels affect the foot



This is unfortunately a progressive condition. Eventually it can lead to arthritis and chronic pain. The sooner you take care of it, however, the more that can be done to correct it.

Dr. Darren Silvester, Dr. Gregory Larsen and our staff at Next Step Foot & Ankle Clinic will use advanced in-office tests to diagnose the condition. Most likely we will need diagnostic images to rule out other causes, then we can begin treatment.



Like other ball of the foot issues that cause pain in the second toe, we try conservative treatments first.

The doctor may suggest treating freidberg's diesease aka. freidberg's infarction by advising you to:



Initially, I would like to get the patient off the foot. Rest is critically important in the early stages of the disease and can stop the process altogether sometimes.

Use of a cam walker, weight-bearing on the heel, the use of a knee scooter can all be very helpful in salvaging the bone before the disease progresses too far.



Medications can also be used. Nonsteroidal anti-inflammatory drugs, L-arginine,  low-dose anticoagulants might be a consideration.

Topical use of transdermal nitroglycerin for vasodilation would also be a consideration.

Freiberg’s Disease: Rare Second Toe Breakdown

minimially invasive

treatment & surgery

for freidberg's disease


treatment & surgery options

Dr. Silvester and Dr. Larsen specialize in many advanced minimally and non-invasive treatments, and if necessaryadvanced minimally invasive and traditional surgical techniques with patient proven success stories.

Some of those are used to treat your freidburg’s disease aka. freidberg’s infarction, such as:

One of the best things for Freiberg’s disease that we have found are custom made orthotics.

They can dramatically decrease the pressure on the bone, and control the biomechanics so the bone can heal.

Check at our page on our custom orthotics (Go4D FitStation by Hewlette Packard). We have the most advanced  system available in South Texas for these devices.

MLS Laser therapy helps to stimulate vascularity.

Click here to learn more about MLS Laser Therapy and how it can help relieve your foot pain.

Shockwave Therapy helps to stimulate vascularity.

Click here to learn more about Shockwave Therapy and how it can help relieve your foot pain.

The literature has been fairly extensive regarding surgical options for Freiberg’s disease. There is good evidence that surgery can decrease stress on the metatarsal head and preserve function.

Simple surgeries such as metatarsal osteotomies just to get pressure off the bone (by making it a little bit shorter ) have been shown to be very effective.

Cartilage replacement therapies have also been used.

The specific surgery depends on the stage of the disease.

Shortening of the bone with some drilling of the necrosed bone is a mainstay of surgery.

Removal of spurs, hypertrophied tissue and loose bodies as well are always done.  

Treat your second toe pain AT THE SOURCE!

Many people suffer from aching, persistent pain the balls of their feet. Dr. Darren Silvester, podiatrist in Pleasanton, and San Antonio TX, provides information on the various treatment options available to relieve your pain and keep you walking comfortably.

Learn more on our website or request to schedule your appointment today!

Take the next step
to happy feet!

Click the links to request your appointment or learn more about what Next Step Foot & Ankle Clinic can do for you.

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