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

The right diagnosis and fusing the toe info

by Kris
(Washington State)

Hi,

I am a 37 years old and was a very active female. My podiatrist recommended fusing my big toe after seeing a 30-40% joint deterioration in my big toe joint via an MRI. My symptoms are burning and pain on the ball of my foot just under the 2nd metatarsal (like a stick is shoved up the metatarsal area and it greatly irritates me when I walk and rest) which also radiates down towards the heal. Other than the second cortisone shot with provided some relief, ice and massage seem to relieve my pain. Back in February, my podiatrist thought the cause was a longer leg, then in July I was told that orthotics will solve the problem – which helped some, but now I am beginning to feel pain in the my other foot.

How can I be sure that the ‘bad toe’ joint is the cause of my pain? I am seriously considering the surgery, but what if this is not the right diagnosis? How can I be sure? Won’t fusing the toe affect my gait and potentially cause more problems?

Thanks!

Hi Kris,
Although fusing the big toe joint is a common procedure I do not particularly like it, especially in young active people. The bigger issue I have is that you state the pain is under your second metatarsal, so I do not know what surgery on the great toe is going to do to help you (other than perhaps you have what is known as a hypermobile first ray and the doctor hopes to stabilize the first metatarsal in order to reduce pain in the second metatarsal).
If that is the goal I would get a second opinion as overall, unless I am missing something here, the proposed treatment does not really fit the disease.
Additionally, if you are as active as you state I am not surprised that your great toe joint has deteriorated 30-40 percent at age 37, rather I think that is to be expected and it is certainly not enough to warrant fusing the joint. Keep in mind, when you fuse a joint, that puts added pressure on the adjacent joints which may lead to deterioration of those joints.
Marc Mitnick DPM

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Nov 22, 2014
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great toe fusion
by: Anonymous

After 6 years of pain and my toe limiting my activities, I had toe fusion. I was very leery as I read all the horror stories. I followed the docs instructions to the tee (unusual for me) and after 6 weeks with NO weight bearing, I got off my crutches and slowly started using my foot again. This was the best thing I could have done. Now 8 months after the surgery I hardly think of it, except for how great it all went. It was probably 3 full months before I could not think about it at all and 6 months until I could fit in regular shoes (not wide).

Dec 23, 2009
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Thank you!
by: Anonymous

Thank you Dr. Mitnick,
Your knowledge is very much appreciated.

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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

MY PRODUCT RECOMMENDATIONS(items I prescribe in the office)

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

Orthotics for heel and arch pain for those who must wear dress shoes click link below

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Click to verify - Before you buy!

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(location unknown)

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Yours truly,

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(location unknown)

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Regards,

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Placentia, California

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Unknown location

I received the orthotics Monday afternoon and began wearing them Tuesday. After two days I would say that I have noticed a huge improvement in the discomfort I have been experiencing. My foot feels better than it has in months.

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Unknown location

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All the best,

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New Zealand

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Sincerely

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Yes I want both pair of orthotics. You don't have an option of ordering 2 at one time so I had to place the order twice. Thanks. My husband likes these and wants to put them in all of his shoes. (referring to Superstep orthotics)

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Arizona

I searched the internet everywhere for a clear description and illustration of my symptoms/problem. https://www.foot-pain-explained.com/ was where I ended my search with answers. If I lived in Jersey (left 30 years ago) and didn't live in Florida I would definetly make an appointment with Dr. Mitnick.

Thanks, Kathy

Florida

1st of all THANKS A LOT for your great site......

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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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Bre

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anonymous

Dr. Mitnick, Thank you, you were 100% correct. The pain finally brought me to the ER. I spent 8 days in the hospital. The Doppler you spoke of was able to show that there was no pulse in that foot. This was an arterial clot that split and traveled throughout my leg. My leg was almost amputated. I am in rough shape but have all my parts intact!! You certainly know what you are talking about. Thank you for taking the time to answer. Yours Truly!

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Poland

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Seattle, WA

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location unknown

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Bill

New Jersey

Thanks so much for answering my question. You've been more help to me than my own Dr. has been lately. Thanks again....I hope to be able to walk without pain someday.

Debbie

location unknown

Wow, that is exactly the information needed!!! thank you thank you thank you!!! I appreciate this help so very much from Marc Mitnick DPM. Excellent information and help to improve One's life.

Chrissy

location unknown

Thanks so much for this website Dr. Marc! It is so nice that you have this ask the doctor feature..I'm sure I'ts been helpful for alot of people. I will try what you suggested and see if it helps...thanks again!

Tracy

Evansville, IA

Dear Marc

I just want to say thank you for the quick response and the good info. I find it amazing and a super nice thing that you do here by answering medical questions at no charge.

Russ W.

location unknown

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location unknown

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Jackie

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!

Rivi,

Albany, NY

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Jill S.

location unknown

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Jackie

Whichita, KS

thanks again, this site is very helpful.

mark

Boston, MA

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....Keep up what your doing. Your a life saver.

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Colorado

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annielou

Colorado

Wonderful advice

by: Anonymous

This is the best site for foot problem info.

Thank you for this information. This description fits my pain and inflammation behind my 2nd toe perfectly.

by: Max

location unknown

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Canada

I just wanted to say that I am very greatful for this website!! I have had a fusion in my rt foot and am finally getting a little bit better......

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location unknown

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Wisconsin

Thank you for your response. You have provided some great insight (to my question)....

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location unknown

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Renae

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

Thanks again doc for having this website and we STILL need qualified Podiatrists in beautiful sunny Tampa Bay (Bradenton) Florida.

Bessie Mae

Florida

Dear Dr. Mitnick, Thank you so very much for taking your time to answer my question. You have greatly relieved my anxiety related to the continual tingly I feel in my feet. I will share your response with my podiatrist next week. God bless you for having this question and answer page on your website! Most gratefully,

Lynne T.

location unknown

Your webpage is excellent, I commend you on sharing your knowledge to the public.

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New Jersey

Thank you. you were more detailed than what others have told me they finally called from the last xrays and my son is now in a cast for 2 weeks he did have a fracture that was not noticeable.

a mom

location unknown

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Lenoir, NC

Thank you so much Doc for a quick and thorough response!

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Bellevue, WA

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Jodi

location unknown

The right diagnosis and fusing the toe info

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