One of the causes of pain at the level of the metatarsal heads is aseptic necrosis or Freiberg’s disease. It is an osteochondritis of the head of metatarsal bones. It is generally observed in the head of the second metatarsal bone in teenaged patients and predominantly in women. This disease occurs due to the overload in the distal metaphysis of the metatarsal bone which causes a fracture due to stress.
The patients with this pathology usually complain of pain and limitation in the metatarsophalangeal joint. In the cases in which the conservative treatment fails or in advanced cases, surgical treatment is recommended.