Seeking Guidance on Chronic Foot Pain Post Surgery
I am reaching out for expert advice regarding ongoing pain in my right foot that has persisted after two significant surgeries and a notable failure of surgical hardware. As an active-duty service member, I am particularly interested in options for diagnosis and treatment that would allow me to avoid joint fusion, as this would have severe implications for my military career. **Surgical History Overview:** 1. **Initial Procedure (Around 10 Years Ago):** A bunionectomy was performed, involving the placement of two screws in the first metatarsal head. 2. **Complications with Hardware:** Approximately four years following the first surgery, both screws fractured without my awareness while I was undergoing Officer Training School. I continued to engage in high-impact activities for about six to seven months, which resulted in persistent swelling and ultimately affected my ability to move normally. 3. **Secondary Surgery (Three Years Ago):** This operation was intended to implement a joint implant for my great toe. However, the surgeon discovered the broken screws during the procedure, necessitating extended time to clean the surgical site and remove the debris. **Current Symptoms:** - **Localized Discomfort:** I experience intense, sharp pain on the left (lateral) side of the ball of my right foot that is exacerbated with any form of pressure. - **Living with Pain:** My walking has become manageable only through the use of custom orthotics that feature a specialized cutout to relieve pressure in that area. - **Expert Opinions:** Podiatrists within the military have reviewed my X-rays and concluded they appear “normal” or “stable.” Their recommended options are limited to either enduring the pain or resorting to total fusion. **Seeking Advice:** Given the lack of clarity from the X-rays regarding the source of my pain, what alternatives exist for further imaging? I suspect there may be nerve entrapment or scar tissue resulting from the previous surgical intervention, or complications related to the positioning of my implant. 1. **Which imaging techniques should I pursue?** (Should I consider options like a Weight-bearing CT, MRI, or Ultrasound to investigate possibilities such as neuromas or bursitis?) 2. **Are there surgical options available that could alleviate pain without leading to fusion, particularly for the lateral aspect of the first metatarsal head?** 3. **Is there a chance of Sesmoiditis or another nerve-related issue stemming from the time I spent on the damaged screws?** I would greatly appreciate any recommendations on what to discuss during my forthcoming medical consultation.
Answers (1)
2/11/2026, 3:01:16 PM
OpenHealth AI
You’re dealing with ongoing foot pain after surgeries and complications, which can be quite challenging, especially as an active-duty service member. It's understandable that you want to explore options other than joint fusion. Let's look at imaging techniques and potential treatment options that could provide relief.
Key Points
- Further Imaging Options: Consider specific imaging to identify the underlying causes of your pain.
- Potential Non-Fusion Surgical Alternatives: Explore viable surgical options aside from joint fusion.
- Suspected Conditions: Discuss potential diagnoses such as sesamoiditis or nerve-related issues during your consultation.
Detailed Explanation
-
Imaging Techniques: Since your current X-rays appear normal, advanced imaging could provide more insight:
- MRI: This can reveal soft tissue problems, including nerve entrapment, bursitis, and scar tissue, which might not be visible on X-rays.
- Weight-bearing CT: This can show the anatomy of your foot under load, allowing assessment of bone alignment and stability during movement.
- Ultrasound: This real-time imaging can help assess soft tissue structures and may identify neuromas or other inflammatory conditions.
-
Surgical Options: If the imaging reveals no significant issues that would necessitate fusion, there are non-fusion techniques to explore:
- Arthroscopy: This minimally invasive procedure allows for the inspection and treatment of joint issues without full fusion.
- Neurectomy: If nerve entrapment is confirmed, cutting the affected nerve can relieve pain.
- Scar Tissue Release: If scar tissue from previous surgeries is contributing to your pain, a procedure to release this can be beneficial.
Next Steps
- Schedule Advanced Imaging: Request an MRI, weight-bearing CT, or ultrasound to explore the underlying cause of your pain in depth.
- Prepare for Consultation: When you meet with your healthcare provider, discuss the specific imaging results you're hoping to obtain and express your concerns about nerve entrapment, sesamoiditis, or any other potential conditions.
- Explore Surgical Options: If imaging identifies a clear cause, ask about less invasive surgical alternatives that do not require fusion but could address the source of your pain.
By taking these steps, you can gather information that will lead to a clearer diagnosis and more targeted treatment options, helping you stay active in your military career. Let me know if you require more detailed guidance on any of these points.
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