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

Fusion of 1st MTP on left foot,

by Gabby
(Homestead Florida)

Hello, I had a fusion of my 1st MTP. I drive a tractor trailer that requires me to double clutch approx. 200 times a day ( so many gears, and long days.) I should also add, that I had to have a sesamoid bone removed during my first surgery ( outer one.) I am having quite a bit of pain in the ball of my foot and the second toe as well. I also seem to have some lower back pain, that I did not have before the surgery. Are these problems normal? Should I look for a different job since the pain is daily? In your professional opinion will this go away ? Thank you


RESPONSE

Hi Gabby

I wish I knew how long ago you had your fusion. This would give me a better idea of where you are in your recovery and might allow me to offer some insight going forward.

It is probably safe to assume that your occupation as a tractor trailer operator is part of the problem and not part of the solution. Constant pressing on the cluth with your foot can only exacerbate the problem because of the excessive stress placed on the ball of your foot.

I would also assume that your previous sesamoid issue was also the result of your occupation.

I am wondering if you wear any special kind of shoe or an orthotic of some sort in your driving shoes, something either in the shoe or orthotic to take pressure off the affected part of your foot. If not, that would be the place I would start.

I would think a rigid shoe or boot that has very little bend at the ball of the foot might be very helpful in taking some of the pressure off your great toe joint and second toe.

A prescription orthotic built in a certain manner to redistribute pressure away from the surgical area might even prove to be more helpful.

If you have not done either of these then you need to speak to your doctor about that possibility.

If you have tried either or both of these options and they have not helped and it has been at least six months from the date of your surgery, then you may be left with a foot that is going to continue to trouble you as you continue to attempt to use a clutch.

Unfortunately, there are some occupations that can wreak havoc on a foot and some times the only way to remedy the problem is to change jobs, but before you do that make sure you have exhausted the other options I have mentioned,

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

DISCLAIMER: The purpose of this site is purely informational in nature. It is not intended to diagnose, treat or cure any medical condition. This information is not a substitute for advice from a medical professional. Please consult your healthcare provider for accurate diagnosis and treatment. The information presented here may be subject to errors and omissions.


SITE LAST UPDATED: APRIL 2026




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(items I prescribe in the office)


Orthotics for multiple types of foot pain
best buy in a pre-made orthotic
click link below


SuperStepOrthotics

Orthotics for heel and arch pain for those who must wear dress shoes
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redithotics

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(location unknown)
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Unknown location

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South Carolina
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Arlington, VA


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San Clemente, CA


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location unknown


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location unknown


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anonymous



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location unknown



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San Diego, CA



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Colorado

Wonderful advice

by: Anonymous

This is the best site for foot problem info.

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by: Max

location unknown
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Canada
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location unknown
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Wisconsin
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location unknown
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North Carolina
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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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location unknown
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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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