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Bunions, Toes & Forefoot Conditions

Freiberg's Disease & Intractable Plantar Keratosis

Causes, symptoms, and treatment for Freiberg's disease and intractable plantar keratosis, with care at 15 clinics across Middle Tennessee.

Part of Bunions, Toes & Forefoot Conditions

Understanding Freiberg's disease and intractable plantar keratosis and your options.

Freiberg's disease happens when the head of a metatarsal bone, most often the second, loses blood supply and collapses a little. Intractable plantar keratosis (IPK) is a deep, painful callus under the ball of the foot that keeps coming back. Both cause pain when the front of the foot takes weight.

Freiberg's is seen mostly in teens and young women. IPK can affect many adults. Care often begins with simple pressure relief.

Also called: IPK

Request an appointmentCall 615-220-8788
Freiberg's Disease & Intractable Plantar Keratosis care

Symptoms

Signs of Freiberg's disease and intractable plantar keratosis.

If you notice these signs, an exam can give you clear answers.

  • 01

    Deep, aching pain at the base of a toe

  • 02

    Swelling and stiffness in the toe joint

  • 03

    A hard, painful spot under the ball of the foot

  • 04

    Pain that returns even after the callus is trimmed

Why it happens

What can cause Freiberg's disease and intractable plantar keratosis.

  • 01

    Repeated stress on a metatarsal bone during growth

  • 02

    A long metatarsal that carries extra load

  • 03

    A bone that sits lower than its neighbors

  • 04

    Past injury to the forefoot

Care groupBunions, Toes & Forefoot Conditions

Diagnosis and care

How we treat Freiberg's disease and intractable plantar keratosis.

Step 1 · Diagnosis

We examine the sore area and trim any callus to see what is underneath. X-rays can show flattening of the bone in Freiberg's disease or a low bone head in IPK. MRI may be used to check bone health in early Freiberg's.

Step 2 · Treatment

Offloading is the main goal. A stiff-soled shoe, a walking boot for a short time, and custom orthotics with padding around the sore area can lower pressure. For IPK, we can safely shave the callus in the office to ease pain. Rest from high-impact sports helps Freiberg's settle.

When pain continues, surgery can smooth the bone, remove damaged joint surface, or shift the bone to relieve pressure. The choice depends on the age of the patient and the condition of the joint.

Recovery

What to expect over time.

Many people feel better after a few months of offloading, though the joint may stay a bit stiff. Recovery after surgery is often two to four months.

When to book

Do not wait it out.

Come in if forefoot pain lasts more than a few weeks, especially in a teen. Also see us if a callus keeps coming back or hurts to walk on.

Call 615-220-8788

Related care

More in Bunions, Toes & Forefoot Conditions.

FAQ

Your questions answered.

Why does my callus keep returning?

A callus grows back when the same spot keeps taking too much pressure. Padding and orthotics aim to fix the cause, not just the skin.

Is Freiberg's disease permanent?

The bone changes may stay, but pain can often be controlled with care.

Get help with Freiberg's disease and intractable plantar keratosis.

Request an appointmentCall 615-220-8788

Where we treat it

Freiberg's Disease & Intractable Plantar Keratosis care at 15 clinics.

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