Numbness and Pain after reconstructive foot surgery

by Cindy
(Murphysboro, IL USA)

4 months ago I had a bunionectomy with screws in big toe, a hammertoe correction shortening the toe and inserting an implant on top to straighten my toe. Also 2nd toe was crossover big toe. I had an implant near outer ankle to correct flat foot. My 2nd toe will NOT go flat on floor. I feel pressure when I walk on it and also a marble on the bottom of my foot below 2nd toe that is painful. From the outside of my big toe, I have painful numbness from top to about my arch. I have hardware and screws on top of my foot at the small bones that are very painful to the touch. I wear thick socks with my shoes to cushion. Overall I feel I have traded one pain for another and I don’t walk as well as before surgery.

Also, several weeks after my surgery, my doctor was looking at my foot and said I should begin to move them manually. She proceeded to push my big toe forward forcefully to the point I drew up my fist to hit her, but breathed deeply and relaxed my fist. I said between clenched teeth “That HURT!!!” She snappily replied, “It’s supposed to “ now do tha 3 times a day. My husband was present. I asked her the next week after doing research if I shouldn’t go more gently increasing the pressure because what she did the week before was painful. Her reply was...oh, that, I’d had a bad week was on call and the kids, you know?!?!?! WHAT? I couldn’t speak. Now she tells me I have bone on bone issue with 2nd toe...HELP

RESPONSE

Hi Cindy,

I wish I had pre-operative and post-operative x-rays to look at, which would be very helpful. I would also like to know what kind of bunion surgery you had performed.

Four months is still relatively early in the rehab process, so there may be some hope for improvement.

You do not mention if you are going for physical therapy or not. If not, I would recommend that over doing stretches at home. Not only will they do better range of motion exercises but will also offer modalities like ultrasound, cold laser, etc. that will reduce inflammation and reduce pain.

Although I am not sure it will do much, I would recommend you purchase a bunion splint (we have them available on our site) to move the big toe further away from the second toe. I am assuming by your description that prior to surgery, the big toe was further under the second toe, but even where it sits now, it is going to be an issue as there is not enough room for the second toe to hit the floor. So by wearing a bunion splint, for the next few months while you are still in the healing phase, the big toe may straighten more.

Even if the big toe straightens, the second toe will not automatically come down to the ground. That may require further surgery, in most cases just a soft tissue release on the top of the toe. You could also try taping the second toe in a downward fashion while wearing a bunion splint and if you were to get real lucky you might see further improvement in the alignment.

If I had an x-ray to look at I might be able to tell you why you are getting pain under the second toe. It is either from the second metatarsal head, or the ligament that attaches the toe to the metatarsal head.

The pain that is coming from the inside of your big toe up to the arch may be from damage to a nerve or possibly a tendon. Physical therapy could benefit both of those issues.

Because of all the issues you are having, you would be wise to consider a second opinion by a local surgeon who can actually examine you.

I would suggest this if you have lost confidence in your surgeon.

Based on her response to you about you, her kids and on call schedule, maybe she should consider giving up surgery until she can put her patients first.

Marc Mitnick DPM
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