Pain in big toe knuckle, post Morton's neuroma removal.

by Dave
(Swindon)

I have recently, 4&1/2 weeks ago had a Morton's neuroma removal of my right foot, usual place between 3rd and 4th toes. The procedure seems to have gone well but after a couple of days of wearing the dressing i seemed to be getting an excruciating pain right through my big toe and big toe knuckle. I asked the doc who said give it some healing time, which i did but got really worried about the pain after 10 days so e mailed the doc. he saw me at the 2 week point, removed the dressing and the stitches. He asked me about the pain explaining that the operation site was nowhere near my big toe but thought the dressing may have been tight enough to aggravate the nerve and to give it a few days to settle down with the dressing off. I am now almost 3 weeks after the removal of stitches and teh dressing and still experiencing excruciating pain down my big toe and on the knuckle. It looks almost like a bunion, the top of the foot is still very swollen and i do not have much movement of the toes. I can however manipulate them. I have rested, used crutches for almost 3/4 weeks soaked them in hot water, put ice on them with no luck. Am I just expecting too much too soon or could the surgery have brought on another problem, ie nerve damage, Bunions or even gout. Extremely worried that it will never be the same again, and I am now gonna have excruciating pain in my foot every single day and not be able to return to my sports interests and studying for a future sports career.

Look fwd to your response

Thank you

RESPONSE
Hi Dave,
Obviously there seems to be a "cause and effect" between the surgery and your new problem even though the surgery was no where near the present sight of pain.
Like your surgeon, my first thought would have been some sort of problem as a result of the dressing on your foot. In theory if the dressing were too tight it might have caused some damage to either the nerve or tendon that courses through the toe thus causing the traveling pain that you mention.
If the big toe was wrapped in a certain manner and forced against the surgical shoe it may have put excessive pressure on the joint which also may have lead to pain in the joint.
This is all conjecture on my part, of course. I would recommend an x-ray just to make sure the joint is fine and if that is the case, then I would suggest some physical therapy in an effort to hasten the recuperation. Therapy would help both an inflamed joint and/or an inflamed tendon.
If it is deemed by your doctor that it is actually the nerve that is causing the symptoms then I would consider oral anti-inflammatory medication or perhaps a cortisone shot at the point of pain.
Bottom line- go with the advice of your surgeon.

Marc Mitnick DPM
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