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The response to the question below was authored by Marc Mitnick DPM
Floating toes ,bunion came back after surgery
failed bunion surgery
Hello Doctor, my feet are giving me big problems and pain and I don't know what to do. On my left foot after my bunion and hammertoe surgery as you can see in the picture I ended up with floating toes that hurt and I also have a terrible pain in the ball of my foot. On my right the bunion came back (even worse than before) and is causing my second toe to go on top of the third toe. I have gotten to the point where the only thing that i can wear are flip flops .is there any orthotics that would help? I work standing up and by the second or third hour of work I just can't bare the pain anymore . I can't have surgery because I lost my insurance ,so is there any orthotics or shoes that you would recommend?
I do not even know where to begin with this case. The enclosed pictures do not help me much other than to say on your right foot, it does not even look like you ever had bunion surgery. Yes, sometimes bunions do recur, but the bump on the side of the foot will at least look like part of it was once removed; yours appears as if no bump was ever removed. At least the left foot appears as if the bump was once removed even though the big toe is drifting toward the second toe.
I would be curious to know how long ago you had your foot surgery. I enlarged your pictures and I can see the scars but they do not look "fresh" so I am assuming these were not done recently.
In any event if you are having pain on the bottom of your feet and no so much with the bunion itself, or the hammertoes per se (even though I see inflammation on top of your second toe right foot), then an orthotic might be of some value.
I say some value because obviously I do not have the option of actually examining you, but in most cases where there has been bunion and hammertoe surgery a patient can end up a destabilization of the ball of the foot where the metatarsal bones attach to the base of the toes.
So you could be suffering from a metatarsagia or capsulitis of some sort.
Trying an orthotic with a metatarsal pad on it, might go a long way in reducing some of your symptoms, in conjunction with a good laced oxford type shoe. Your days of high spiked heels are probably over.
In addition to the metatarsal pad, you would require an orthotic that actually supports your arch thereby reducing some of the pressure on the ball of your feet. Additionally, the orthotic should be of a cushioning nature so the ball of the foot in not pressing on the hard surface of a shoe, particularly if you stand long hours during the day.
If you are looking for an affordable orthotic with all these features, take a look at my SuperStep orthotics which can be found in the right column of my home page.
A good orthotic along with a good pair of laced shoes made of soft material to accommodate the bulge of your bunions and your second toe right foot should go a long way to making you more comfortable, but it will not totally solve your problem.
At this point I might add that further surgery, when you have insurance, is not always the answer either.
Hopefully, your original surgeon discussed the possibilities of surgical failure prior to your surgery and you accepted that as one of the risks. You cannot always fix what has become broken through more surgery. Each surgery leaves you with more scar tissue which results in more limitation of motion in the joints and therefore less function. Plus, it is usually harder to do a second surgery on a previously operated site, simply because the tissue under the skin is not as viable as it was before the first surgery.
So, if you can find a relative degree of comfort through proper shoe selection along with a decent orthotic then thats about as good as it will probably get. If that combination offers no relief to you, then at some point in time you would have to consider further surgery.
Next time, make sure you get a second opinion before doing anything.
see related article.... capsulitis
see related article.... metatarsalgia
see related article.... surgical consideration
Marc Mitnick DPM
Johns Hopkins Medicine
University of Rochester Medical Center
American Academy of Pediatrics
Penn State Medical Center
National Institutes of Health
Columbia University Department of Rehabilitation
Stanford Health Care
Illinois Bone and Joint Institute
Mount Sinai Hospital
Institute for Chronic Pain
University of Florida Health
American Family Physician
University of Maryland Medical Center