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The response to the question below was authored by Marc Mitnick DPM

Arch pain

by Lee
(Utah)

I had a bimalleolar fracture in Jan of 2011 with dislocation and had orif with 1 plate and 6 screws placed. I have been having a lit of burning/aching pain in bottom of foot directly in the arch area, that seems to be progressively getting worse. I have seen my OS and we did nerve study to rule our tarsal tunnel syndrome. Also been having some other pain associated with hardware and will be having it removed later this week but dr doesn't seem to be addressing arch pain, my question is if I'm going to have surgery anyways should I push harder for him to try and resolve arch pain? Is there something he could look for or do during surgery that could fix this pain? If it isn't hardware related what else could it be? Thanks for your time!!

RESPONSE
Hi Lee,
It is hard for me to know why your arch is bothering you without having the luxury of actually examining you, but I could go out on a limb and assume it is related to the trauma in your ankle and the subsequent surgery and recuperation.
Making that assumption would then lead to the next statement and that is that you probably do not have a surgical remedy to your arch pain.
First of all you need to have an accurate diagnosis as to why you are having arch pain in the first place. Without a true diagnosis it is impossible to institute therapy.
We at least know that you do not have a tarsal tunnel issue, but was there any direct trauma to the arch area as a result of all the hardware you had around your ankle area? If so that could account for the arch pain.
Another consideration is the fact that with all the hardware in your ankle, once you started to walk, your gait was obviously altered so that too may have contributed to your arch pain.
So as you can see there may be reasons your arch is hurting that are related directly to your surgery and so in that regard would not require surgery.
I am on the outside looking in but your surgeon should obviously be more familiar with your situation and he or she would be the one to best judge whether or not your arch pain is related to your surgery or is a new problem. So...my suggestion would be to just ask your doctor if the pain in the arch is related to your ankle trauma. If the answer is yes, I would do nothing with the arch; have the hardware removed, have physical therapy, try and return to a normal gait and then evaluate how the arch feels. I would think there would be a good chance the arch symptoms will improve.

Marc Mitnick DPM
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ADDITIONAL REFERENCES

Mayo Clinic

Johns Hopkins Medicine

MedlinePlus

Arthritis Foundation

University of Rochester Medical Center

Harvard Health

Drugs.com

American Academy of Pediatrics

Penn State Medical Center

National Institutes of Health

Columbia University Department of Rehabilitation

ScienceDirect

Stanford Health Care

Illinois Bone and Joint Institute

Mount Sinai Hospital

Institute for Chronic Pain

University of Florida Health

American Family Physician

Cedars-Sinai

University of Maryland Medical Center

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(location unknown)

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(location unknown)

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Unknown location

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Poland

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Seattle, WA

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New Jersey

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Evansville, IA

Dear Marc

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San Diego, CA

Dr. Mitnick, Just want to say thank you so very much for your quick response and very informative reply! After reading what you had to say, I called the doctor's office and was able to get in and see him the same day as my injury. Toe was x-rayed and luckily, it is not broken or fractured. Very badly bruised and will probably lose the toe nail. And although my toe and toe nail are still very black and blue and very sore, they ARE both starting to feel a little better. So again, thank you! I am so very happy that I came across your website. The service you provide is outstanding and immeasurable!

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Albany, NY

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Whichita, KS

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Colorado

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Colorado

Wonderful advice

by: Anonymous

This is the best site for foot problem info.

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location unknown

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Wisconsin

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North Carolina

Many Thanks Dr Marc!
Thank you for your response. It sounds like a good plan to me. He did not cut the wart out first ...

KG

location unknown

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Florida

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New Jersey

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a mom

location unknown

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Bellevue, WA

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location unknown

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