persistent foot pain even after two surgeries

by Debbie
(USA)

I have had terrible bunions for 25 yrs. I had left foot bunionectomy and osteotomy 9/06 and left foot MN surgery 12/07. The problem is I still have the same pain as before. The arch of that foot feels like it has a cramp all the time. The outside and top of that foot about an inch behind the base of my little toe hurts terribly if I'm on my feet for any amount of time. I've been wondering if maybe I have a tailors bunion but it doesn't really have much of a bump there but does get red when I've had shoes on. I never wear tight shoes or heals. I need advice and info. Please!!!!!!

Hi Debbie,
I am not sure I know what "MN" surgery is and since I cannot examine you I will speak in generalities. Your problem is not unique; there are people who will undergo foot surgery and be no better off afterwards. This is one of the risks of this type of surgery and hopefully your surgeon bothered to mention this to you.
Since you state you had terrible bunions for 25 years I will assume consenting to surgery was the right thing to do.
Your smartest move would be to get a second opinion from another doctor, totally removed from the first doctor. Does the foot look better but still hurt, or does the foot look basically the same as it did before surgery and still hurt? There is a big difference depending on your answer.
Keep in mind that more surgery is not always the answer. I tell my patients all the time that doctors on their best day cannot do as good a job as the "man upstairs" did when he originally put us together.
Every time you have surgery particularly in a previously operated area you run the risk of more scar tissue. less motion in the bunion joint and more problems. So, if the previous surgeries made the foot look better but it still hurts, I do not know if further surgery will help.
However, if the previous surgery resulted in the foot looking basically the same as prior to surgery, additional surgical procedures may be indicated.
You may also have to come to the realization that you cannot wear the types of shoes that you like and have to go with a more conservative type shoe. Physical therapy at this point would probably be useless, but I wonder, did you have therapy after the surgery?
I hope I have given you some guidelines but certainly get a second opinion.
Marc Mitnick DPM