Peter Hibberd, M.D., is a doctor whose advice is based on more than 28 years of hospital outpatient and inpatient experience. He is an experienced emergency medicine physician, surgeon, and consultant. Dr. Hibberd is certified by the American Board of Emergency Medicine. He is also a fellow and active member of the American Academy of Family Physicians, an active member of the American College of Emergency Physicians, and a member and fellow of the American Academy of Emergency Medicine. Dr. Hibberd has earned numerous national and international professional certifications, memberships, and awards.
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Surgery to Relieve Foot Pain

Monday, 25 Oct 2010 09:13 AM


Question: The bones in the joint of my foot were surgically fused about six months ago. Prior to the surgery, I had undergone the usual cortisone shots, physical therapy, etc. for over a year. The surgery was supposed to take the pain away, but it's more painful than before. CT scan and X-rays look OK, and my surgeon has no explanation. Any ideas?

Dr. Hibberd's Answer:

Foot surgery involving fusion intended to relieve pain is usually done as a last resort. Post-operative foot pain can be as elusive as victims of back pain who see no improvement in their pain after surgical fusion.

Unfortunately, fusion of painful joints will only relieve pain if the primary cause was joint- or bone-related, and even then the results are not 100 percent. We, of course, assume that the fusion was technically successful … not all fusions actually achieve the fusion desired … and perhaps further procedures may be necessary to achieve a complete fusion.

Our feet are actually composed of multiple small bones held together by a weave of ligament and tendon structures within tendon sheaths. Disruptions and misalignments of the support structures around the bones of the foot and ankle will also cause pain. These structures are usually visualized well by MRI.

Unfortunately, surgical fixation using wire and screws may preclude you from having an MRI, so other diagnostic modalities are going to be needed. I recommend you seek a second opinion from an orthopedic surgeon who specializes in the foot and ankle, and you may even seek a neurology consultation to be sure this pain is not related to nerve damage.





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