Freiberg’s disease and the Little Piggy rhyme

This little piggy went to market

This little piggy stayed home

This little piggy had roast beef

This little piggy had none

And this little piggy went….wee wee all the way home

Mothers, over the years, have always recited the nursery rhyme of the ‘little piggys’, while counting out on their baby’s toes with each line corresponding to a different toe – usually beginning with the big toe and ending with the little toe – and finally tickling the underfoot at the last line of the rhyme.

Little did one know that with puberty, ‘the little piggy that stayed home’ could end up with a problem known as Freiberg’s disease. It is a rare disorder of the foot’s metatarsal joints, generally developing in the second toe. 80% of the people diagnosed are women who are young, athletic and have unusually long metatarsals. Freiberg’s disease is a form of avascular necrosis in the metatarsal, which in laypersons terms means the death of bone tissue due to a lack of blood supply.

Causes of Freiberg’s disease

  • Foot injury or trauma
  • Having longer-than-normal metatarsal bones
  • Wearing very high heeled shoes

Symptoms of Freiberg’s disease

  • Pain localized to the head of the second toe
  • Swelling and stiffness in the metatarsophalangeal joint
  • A slight limp
  • Possibly a callus beneath the affected toe

In its earlier stages, Freiberg’s disease may heal without treatment. However, supportive footwear with a pad underneath the involved bone; resting the joint to alleviate pressure by reducing weight-bearing activities; orthotics and cortisone are also recommended.

If conservative treatment does not help, then a podiatrist may consider immobilizing the foot in a walking cast to restrict movement. When all else fails, then surgery becomes necessary to reduce the bone mass of the metatarsal.

Where surgery is involved, one needs to choose a podiatrist wisely. If you reside in the Syracuse area, visit our office Syracuse Podiatry located in Fayetteville, NY. Our board certified podiatrist, Dr. Ryan L. D’Amico is a specialist in all pedal problems including reconstructive foot and ankle surgery. He is assisted by a professional and caring team, who go beyond the call of duty to make their patients comfortable and happy. You may reach us at (315) 446 3668 to schedule an appointment.


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