post hammertoe surgery complications-toe pain

by beth smith
(baltimore ohio)

I have written before regarding pain and stiffness in toes 6 months after hammertoe surgery. I went back to doctor and We noticed that the 2nd and 3rd toes still don't hit the floor they stick up. He is having be put on biofreeze and do exercises with my toes then ice them each evening after i get home from work. I go back in 6 weeks to see him. So far it doesn't seem to be doing much (3 weeks now). He said if it doesn't work then injections will be next. This I dread as I've had injections before I had surgery for the hammertoes. They didn't work, which is why I had surgery. I also had mortons neuroma surgery along with hammertoe surgery. Can you tell me what the injections are about? Also what would maybe be the next step after injections if the possibility they would not work?

Hi Beth,
Based on your story, I would think your doctor feels the lack of toe purchase is due to excessive swelling, so in an effort to reduce this swelling he is having you exercise the area and if that does not work, I assume he wants to give you cortisone injections to reduce the swelling. (this is just my guess).
You might ask him about seeing a physical therapist to really get a better regimen of treatment then the Biofreeze and exercises he has you doing. Physical therapists do great work.
Instead of additional injections, you might ask your doctor about oral anti-inflammatory medication as an alternative.
Good luck.
Marc Mitnick DPM

painful toe

by Kathy
(Lewisburg, Pa. 17837)

I had very bad pain in my foot and some swelling went to the doctors--first he said it was broke on the under side of my big toe fit me for a boot--then he gave me shots--then said he would do surgery and asked why, he said to find out what is wrong---it is a burning hurt from the top to my big toe and down the side. Sitting does not make it better and some times the pain is so bad I can't walk on it. I told the doctor that anything on my foot even my bed sheets seem to much weight. I had x-rays and bone scans--MRI,s and without a answer. What do you think it might be--oh he did find some arthritis in my ankle and in my joint of my big toe were it meets my foot he gave me shots the first did nothing and the second just for a few days.

Hi Kathy,
One thing that can cause burning in the area you describe is a nerve entrapment in the area; the fact that you have arthritis in the big toe joint might mean one of the local nerves is being "pinched" between the shoe and your protruding bone spur. Of course, I am only guessing since I cannot examine you. But, here is what I would suggest. This doctor does not seem to have any kind of definitive diagnosis and I certainly wouldn't allow him to operate on you to "try and find out what is wrong with you". Your better bet would be to get a second opinion.
Marc Mitnick DPM

pain left foot bottom bump that moves.

by stacy
(gainesville, fl, usa)

left pinky toe calouse than after callous is the bump.slight right towards middle. when i rub it i can feel it pop and move. it hurts some times so bad i cant step on the left side that i try torub it out sometimes it helps sometimes it dont. also i get foot cramps inthe arches of both feet. i dont have diabetes.

Hi Stacy,
Unfortunately I cannot enlarge your picture so I cannot really see the growth. If you can make it move, two things come to mind. One would be a plantar fibroma and the other would be a ganglion cyst. You can read about both conditions on my site.
Since the growth is something that should not be there and since it hurts I would think you would be best served by seeing a local podiatrist and find out exactly what it is and have some helpful treatment.
Marc Mitnick DPM

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Painful knot

by NOODLES39
(NAPTOWN, MD)

the knot was smaller about 1 week ago, now it has become a little bigger. it hurts to wear heels because of the location of the knot...when i push hard on the knot, it HURTS! it's sort of soft on the outside but you can feel the knot inside, no openings on it, same color as rest of skin but redness is present. the knot is visable when looking at the bottom of my foot. WHAT IS IT, IT HURTS!?!?

RENAE

Hi Renae,
The most common "knot" on the bottom of the foot is due to a plantar fibromatosis, of course without actually examining you, I do not know if this is actually what you have.
Two points: you have a lump that does not belong there and you have pain. This would be two good reasons to have a doctor look at it.
Marc Mitnick DPM

Pulled gastrocnemius tear/pull with concomitant leg and foot numbness?

by Patrick
(Modesto, CA, USA)

Approximately 5 days ago, I experienced a "pop" and a sharp pain in my calf muscle while doing sprints. I have been using ice, rest, and anti-inflammatories. The pain has subsided to a degree, but I am still unable to push off of my toes while bearing weight. Interestingly enough to me, I can point my toes with minimal pain, but as far as lifting up on my toes, I cannot do so without significant, sharp pain. What has me most concerned is that I also am experiencing leg numbness (the lateral side of my calf as well as the posterior), down to the lateral side of my foot and covering from my heel forward to the base of my small toe.

I did do a great deal of icing initially, and I do not recall having this numbness initially. I'm wondering if this numbness is abnormal and if I should be concerned. Currently, I am continuing with rest and AI meds.

I am 40 years old, a lifelong athlete, and in very good physical condition.

Hi Patrick,
Hard to make a diagnosis 3000 miles away but I would be concerned about a tear of the gastrocnemius/soleus complex. The numbness may be nothing more then just pressure on the nerves from any local swelling in the area.
The best advice I can give you is to see a doctor in your area and have an accurate diagnosis made. These kind of injuries need the proper treatment in order to heal properly.
Since you are 40 you have reached the point in life where an injury such as this will keep you off the track for quite a long time if not treated appropriately.
Marc Mitnick DPM

pain in big toes on walking

by Carol
(UK)

The bottom outside edges of both big toes have developed thickened skin, which I do remove regularly, and try to soften with moisturiser. However, they are both very painful when I am walking or driving. Have I damaged the nerves beneath the skin? This has been a problem for some years now, and seems to be worsening. I am a 60 year old woman and have osteoarthritis.

Hi Carol,
More than likely it is more than the callus that is causing pain.
People with calluses on the medial side of the big toe tend to be flat footed and walk off the inside of their big toe. Over time the nerve that passes in that area may get inflamed. Additionally many people develop a bone spur in that area and that will exacerbate the pain.
So, scraping and moisturizing the callus will only give you partial relief.
Your best bet would be to consult with a foot specialist, have an xray and get a full evaluation.
Marc Mitnick DPM

Pain after Fusion

by Patty
(Rome, New York, USA)

I had a 1st MTP fusion on January 25, 2010 and am still having pain. The pain is on the plantar area below big toe. My doctor (a foot and ankle OS who left the area to return to Wisconsin) says the fusion is healing well and looks good. The bone shows good healing. I asked him about pain this far out and he says it is my foot getting adjusted to the fusion. He also says this is my 2nd surgery and will take more time. I had a Austin bunionectomy and shortening of second metatarsal on April 8 ,2008. After that, I had pain in the sesmoids (wrote in before on this) and developed arthritis in the joint. Got several options and opted for fusion instead of removing the sesmoid. Had PT for 3 weeks which consisted of whirlpool, massage, and ultrasound. Please advise. This is ruining my life. Thank you.

Hi Patty,
Sometimes the more surgery you have, the more complicated the problem becomes.
The first thing that comes to mind based on where you state your pain is occurring, would be the angle that the big toe was fused at, relative to the first metatarsal bone.
If the pain is occurring on the bottom of the big toe then I would suspect that the angle may not be great enough and you are putting too much pressure on the big toe when you walk.
If the pain is further back then it might be your sesamoids that are being irritated. If that is the case then having one removed might not be an issue since your big toe is fused and therefore could not deviate left or right.
There are probably inserts that could be added to your shoes to better distribute you body weight as you walk, but you would have to see a local doctor for an evaluation. Since your surgeon has left the area it might not be a bad idea to get another opinion.
Marc Mitnick DPM

post op bunionectomy swelling

by Dolores B.
(San Leandro, CA, USA)

I had bunionectomy & osteopathy done on my right toe Oct 29, 2010. This is the 5th week & I'm still wearing a boot. I have been walking around without the aid of either crutches or cane, slowly. I also massage & exercise the toe several times a day & am able to apply some pressure on the whole foot while walking.

My question is slight swelling & numbness where the bunion was removed. Would icing for 20 minutes every hour help reduce swelling & numbness? Please advise, Dolores B.

Hi Dolores,
Icing and elevation would certainly help with the swelling, but you should ask your surgeon what he or she would recommend. Your surgeon is responsible for your well being and your question is a legitimate one.
Keep in mind, it can take bunions upwards of a year to heal due to remodeling of the bone in the osteotomy site, so swelling is normal. As long as you notice some degree of improvement each and every week compared to the previous week, you are doing fine.
Marc Mitnick DPM

Pain outside of foot forward of heel

by Gabriele
(NM)

I am a 73 yr. old female. According to your diagram, the pain is caused by irritation of the peroneus longus tendon.
Shoes are not tight, and the pain also exists when barefoot. There is no apparent swelling or external inflammation. I placed an ice pack at the site, and the pain diminished. (I had tried wrapping the foot with an Ace bandage before the ice treatment, but the bandaging made the pain increase). I visited a podiatrist yesterday. He took an x-ray, and also ultrasound. He said that cortisone shots may delay healing. He recommended a boot for two weeks and then an ankle brace for the subsequent two weeks. That appears to contradict your suggestion to another inquirer. What procedure do you suggest for this problem?

(Last year I had plantar fasciitis in the other foot. It was treated with a series of cortisone shots, ice and an ankle brace. It resolved).

Hi Gabriele,
Every doctor has their own methods in treating certain conditions. I prefer a cortisone injection for this condition or oral anti-inflammatory medication but that is my preference. Technically a cortisone injection does delay healing,BUT, it should also relieve the pain and if you are in a lot of pain, I think that overrides the delayed healing.
A compromise might include either an injection or medication, along with the boot. You will need to discuss that option with your doctor as he is the one actually treating you.
Marc Mitnick DPM

Pain top of foot

by Julie
(Boise ID)

Hi,

I just recently went on a trip and drove for many constant hours two days in a row. The day that I got home my right foot was sore and tender when walking. The next day however I hardly can walk on it and it is very painful. I did go into the ER and they did an xray. No sign of a break. My foot however on the third day is just as bad if not worse. Looking at the foot there is mild swelling but not much. To explain exactly where the pain is if you were to look down on the top of the foot the pain is in the middle of the foot diagonal from the big toe. What could possibly be wrong with my foot? Should I be concerned? How can I treat it?

Thank you for your time and help

Sincerely

Julie

Hi Julie,
Since there is no fracture (which I would not have expected anyway), more than likely you have tendonitis of the tendons on the top part of your foot from holding your foot in a certain position for so long while driving.
I would apply moist heat and take anti-inflammatory medication for 10-14 days (if you are allowed to take that type of medication) and the pain should subside and eventually resolve. Also, restrain from excessive walking and athletics over the next two weeks.
Marc Mitnick DPM

Needle like sensation while walking.

by Brittney
(Salinas, CA, USA)

I recently have gone through different pairs of running and walking shoes. I have try and bought many different ones because they all appear to do the same thing to my feet. They tend to make the outer sides (both feet) have sharp needle like pricks in them. This doesn't happen when I wear shoes that have absolutely no foot support on the inside of them. The sensation feels like there is a rectangle of needles all sticking straight up and going right into the side of my foot. Can you help me figure out what is causing this pain? I want more support when walking, but my feel do not like any of the shoes. I have also just tried to stick it out and hope that breaking them in will help and I have had no luck. I would also like to add that I do not have flat feet or high arches.

Hi Brittney,
By wearing an arch in your shoes (vs.wearing flats) you do two things to your body. One, you put more pressure on the area of the feet that hurt, but I am not so sure that is the source of your problem. Second, you may be changing the alignment in your lower back and that "could" be the source of your pins and needles.
This is only a guess on my part, I think you would be wise to seek medical care to determine the source of your pain.
Marc Mitnick DPM

Pain Under Second Toe

I have, I believe a hammer toe on the second toe of my left foot.

The pain, however, is underneath the second toe, under the pad at the rear of the toe where it connects with the sole of the foot. It has felt like I've been walking on a marble for several weeks. When I press on the pad, it hurts, as if there is something growing under the skin.

The foot is not discolored, nor is there any redness or swelling around the area I am describing. While sandals and one pair of shoes seem to work better than another, the pain is still there (albeit to a lesser degree) and the walking on a marble or stone feeling remains.

Any thoughts?

I am a Type 2 diabetic, taking Metformin and Glucophage, but blood numbers are in the teens with an A1c of 5.8.

Ron

Hi Ron,
In general a diabetic should always be examined by a podiatrist probably on a yearly basis, even with controlled sugars.
Your pain specifically sounds like capsulitis. You can read my section on the subject and see if it describes your problem. In most cases with some shoe or innsole modification the condition can be controlled without requiring hammertoe surgery.
Hook yourself up with a good podiatrist to treat your pain and educate you about diabetes and the foot.
Marc Mitnick DPM

Pain in the top of foot due to accident

by Jill
(Orange County, CA)

Was slamming on the brakes when I rear-ended vehicle, and as a result, I have pain in my right foot. The pain is on the top of my foot, and it is very tender close to where my ankle bends. I feel the most discomfort when I try to move my foot side-to-side (when wiggling foot into a shoe, for example). I have almost not pain when going back and forth, like in walking. Any idea what the problem is and what I need to do?

Hi Jill,
Obviously you damaged something as a result of the accident. If the pain has persisted longer than a week, you really need to see a doctor and have an x-ray, that is the only way you will find out what you did to yourself.
Marc Mitnick DPM

Pain on top of my middle toe and around the toe nail

by Rick
(Indianapolis, IN)

Over the last several nights after retiring, I have been experiencing pain on my right foot's middle toe. The pain seems to be coming directly on top of the toe and around the nail, not at the joints (thought it might be gout).

Now even during the day it is hurting and never seems to go away. There is no redness on the top or nail, although the area is very sensitive when touched (more than the constant pain that is very bothersome).

Over the last week or so, I have noticed on my leftr foot that at night when sleeping under a sheet and light blanket, the top of several toes seemed to tingle and hurt on the top as well. This went away and now has taken aim at my right foot.

I haven't trimmed my toe nails lately that could have caused the issue. Hurts even when shoes are removed (no new shoes or sneakers either). Any idea what it might be??

Now that i look more closely, the entire toe does seem to be swollen more than the right toe.

Hi Rick,
Just guessing here, since I cannot examine you but sometimes people develop infections at the base of the nail usually from nothing more that the nail being pushed backwards in the shoe.
Other things to consider would be gout at the joint just behind the nail, as well as an arthritic flareup of the same joint, as well as possible vascular compromise to the ends of the toes due to the cold weather.
If this process continues over the next few days I would suggest you see a foot specialist in your area and get a proper diagnosis and treatment.
Marc Mitnick DPM
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pain and soreness

by Debra
(Western North Carolina)

Pain in the foot at the base of the second and third toe . It really hurts to apply pressure or weight on my foot. It almost feels like the pain you feel when you pop your toe but it doesn't go away. The pain is really intense and feels sore.
I haven't injured it that I'm aware of by exercising or running or anything like that.. It just started hurting and is getting worse. My job does not require me to stand, rather I sit all day. I'm 44 and I do have two small children that are very active. I have been diagnosed with Fibromyalgia for about 3 years. Please help!

Hi Debra,
The two most common causes of pain in the area that you mention are Morton's neuroma and capsulitis. Read me section on each of those conditions.
There does not have to be a history of trauma for these conditions to occur.
If you have had this pain for over a couple of weeks, chances are it is not going to go away on its own.
You can try an orthotic but more than likely you will need professional help.
Marc Mitnick DPM