I barely know where to begin. My foot problems stem from arthritis in the large joint/big toe. I have undergone four surgeries in the space of two years: (1) reconstruction of the joint, (2) joint implant, (3) bone fusion with external fixater (I was on crutches/non weight bearing for six months), and (4) removal of the plates and screws a year after surgery. As far as I'm concerned the bone fusion surgery is a failure. I am in more pain now than I was to start with and would go back to the joint implant in a heart beat. The reason the joint implant failed was due to my development of fibrosis in the surgical area which resulted in pain because the joint was unable to move. These surgeries took place between 1999 and 2001. Throw in surgery for a ruptured disc/cervical and 3 months/24 hours a day in a hard collar, among other health issues, as well as the loss of both parents and a brother during that same time frame, and I suppose it's no wonder I'm suffering from depression. I have tried series of injections in an attempt to help with the nerve pain in my foot to no avail. I am currently taking Lyrica but can only take it at night because it makes me drowsy/dizzy. It is difficult to walk, my weight (what there is of it) is thrown to the outside of my foot which has resulted in a painful ankle, sore foot, painful spasms in my other toes, and the list goes on and on. Shoes?!? I would love to find a pair of shoes that aren't painful. I can't even wear sneakers. I am stuck wearing clogs which have recently started bothering me -- atrophy of the foot has progressed to the point where I can't keep an open shoe on my foot. I walk right out of it. And clogs are so chic -- try figuring out what to wear to a wedding, etc. when you can't wear shoes. I know that my problems are minimal compared to what some people go through in their life, but that thinking doesn't help me. It only makes me feel worse. I'm tired. I've been from doctor's office to doctor's office seeking help. And I suppose my question is, has anyone gone through what I have and is there any surgery that would improve my condition. Can I go back to a joint implant. I already know what the answer is. There is no help for me and I have to face the fact that I will live with this pain the rest of my life. Any suggestions to alleviate the pain?

Tweety, I am really sorry to hear about your story. I am a little bit behind where you are; next week I have my great toe joint fused together with a bone graft off my hips. If you search by my name, you should be able to find the thread I started.

I can understand your depression, I would imagine that everyone here can identify with it. I don't have any advice for that, it does help to talk about it, and I have enjoyed posting on this site and reading the responses I get. There was a time after I had my implant put in where I stopped going to doctors, just because it got to where I wasn't getting any new answers, just the same old stuff, and you get tired of hearing it after a while.

Are you currently under anyone's care? If not, I can suggest the ortho doc where I am going, he seems to be pretty good.

hi tweetie, depression is a normal way of living after foot surgeries you had. its so sad that is has to be this way, but there are other options to try i think. i also had toe fusion after 2 failed surgeries. we use our feet to get around. i hope you are seeing an ortho now and trying pain management. i wish i knew what your dr told you. plus, i dont know how long it has been for you. there is no going back after fusion, but something else has to be done and maybe its a new fusion. i would seek several opinions. this board is a wonderful place to vent. maybe there are other people in your area that you can talk to. i cant stand not to be able to wear cute shoes, but i am walking. that i am walking without pain in sneakers is wonderful, but sometimes i would like to burn them. if you didnt have the pain, you would see things differently. i hope there is a dr outhere who is listening now. keep posting. debbie g

I had bone fusion of my right great toe 7 weeks ago and I'm still in a lot of pain. The doctor says everything looks great and alignment is correct. Wondering if anyone else has pain this long after surgery. I have quite a bit of redness and some swelling yet under all the toes and it burns quite a bit. Is this my foot rejecting the pin. I see the doctor this coming Tuesday and he will do an x-ray and says I might be able to start walking. How can I with so much pain?

Tweetie, are you still out there? Have you made any progress in the last two weeks? So far so good with me, I will be happy to recommend the place I am going if it would help you.
Lyndie, sorry to hear you are still in pain after 7 weeks. I am 1 week post-op; next week the stitches come out of my foot and I get a cast for a few weeks. Hopefully I am not in the kind of pain you are in after 7 weeks. We would like to hear from both of you, don't give up.

Thanks for the reply dbgoalie. I went to the doctor back on October 30. He took an x-ray and said I am not quite healed all the way through, but that I could start walking if I don't roll my foot onto the toe. I asked him why I was swelling on the bottom of my foot at the base of the other toes. He didn't have an answer, said "I didn't do anything there."

He said everything looked great and couldn't explain why I had so much pain. I started walking with a walking boot and it actually made my foot feel better. I seem to be progressing each day now. I go back November 20th and hopefully the fusion will be healed. I think my pain is related to nerves healing. I get a lot of tingling and some burning when I am barefoot, less and less swelling. My foot actually feels pretty good in the walking boot. I put on a regular sock for the first time today. I do get a sensation like a rubber band being pulled tight around my big toe every so often, but not as often as before. Things are looking up! Can say at the moment I'm glad I went through this. Hope things go well for you.

Funny how different doctors do things. My doctor didn't take the stitches out until 3 1/2 weeks and I never had a cast.

Lynide, give me a little history of what you had done please. This is operation number three for me. Broke joint of big toe when I was 15, had it cleaned out and a pin inserted for a few weeks to straighten when I was 30, at 34 I had an implant put in the joint since the cartilege had died, and at 37 (2 weeks ago) had the implant taken out and the joint fused. Hardware is holding the toe and foot together across the joint to allow it to fuse; the hardware will stay if there is no issue with it.

Do you have a pin in your foot or do you have a plate there? Funny you mention having pain on the bottom of your foot, I had the same problem after the implant was put in and it never really went away; I always had swelling and tenderness for years that never went anywhere. My doc said the same thing, he did no work there and couldn't explain. We tried therapy and I would see mild improvement, but it wouldn't last. If the therapist worked out the swelling, it would return. Personally, I think the swelling in the area was a reaction to the hardware, but no one would ever agree to that. My feeling was the implant would rub against the foot and the base of the toe as I walked, and that would generate the swelling in the area. The plate that I have currently in my foot is stationary, there won't be anything moving back and forth on it, so I am hopeful there won't be any swelling once I am recovered from surgery.

Nice description of the rubber band being pulled tight around your big toe. Now I am only 2 weeks post-op, and I also get that sensation every once in a while, like a sharp shooting pain through my toe that doesn't last long but it gets my attention. I wonder if that is a nerve shooting off or if it is something related to the bones fusing together? But that's a good description of the sensation.

dbgoalie, I wonder about the hardware rejection issue, too. My history is not nearly as long as yours. My toe has been hurting off and on for about 2 years. The joint at the start of the year was pretty inflamed and swollen when I went in for my yearly checkup in March. My family MD said he thought I had gout, which I didn't really agree with and he didn't check any bloodwork to verify that guess. Anyway, it still hurt and on June 1. I went to a podiatrist to see what he thought. He took an xray and came in and said he had bad news, I had arthritis and in the top 10 worst cases he'd seen, mine was in the top five. He said I had no cartilage left. It was bone on bone and my toe was totally stiff, hallux rigidus. He suggested either a HemiCap or bone fusion. So I took a little time and got a second opinion from an orthopedist and he suggested with being active, swimming, walking, gardening, etc. that the bone fusion would be a better option for me and that I was already past the HemiCap. He said I would need a total joint replacement. I had discovered that my insurance wouldn't pay for the HemiCap (because it is considered experimental) and the ortho said the total joint probably wouldn't be covered either. So I opted for the bone fusion.

I blame my foot problem on going barefoot all the time. I know I have smashed my toe many times. But I told the ortho that when I step in water and then step on concrete, my footprint is only the front of my foot and the heel, there is no side of the foot in my footprint. He says that means my foot tips to the inside putting all the weight of foot on the big toe. That is probably the main cause. Anyway, I sure wasn't looking at having to have surgery, but I don't like putting off the inevitable and having the pain I had before surgery. Hopefully, this will help in the long run.

The procedure included cleaning up the joint. I had a few bone chips and a protrusion on the side of the joint. Then the joint was smoothed and I have a pin going diagonally, but no plate. The pin is supposed to stay in place unless there is a reaction. I thought I was getting a reaction, but doc says I'm fine.

The pain is getting better. Still have the same sensations but they are getting less strong. How you doing?

Forgot to mention that there was a complication during the pin placement with the bone fusion. The guiding wire broke and they would have left it in there and used a different one but it popped up through the bone. In order to retrieve the bone, the ortho made in incision under the toe to pull the wire back out. I had a couple of stitches in the bottom of my big toe. Now I have a knot in that spot, probably just scar tissue.

hi lyndie, sounds like you are doing well. i cant believe you only have a pin.

The pin is pretty long and goes diagonally and I swear it is causing most of the pain I have. I haven't had a cast at all. I am getting around in a walker boot now and I actually feel better with the boot is on or at least having my foot wrapped. It's like the blood gets down to the foot and doesn't know how to go back up. If I'm barefoot, I need to massage it to get the blood circulating again, but if it's wrapped it seems to circulate better. I'm still not driving, but went back to work at 10 days after surgery on crutches. I work at a hospital and our office is the closest to an entrance (everyone helped me out so I didn't have to do any walking--just to the restroom and back). Sure is better now that I don't need crutches!

when does the pin come out?

Doc says it won't. Is that right? Do they usually come out?

if you feel the pin is causing pain then something has to be done. i would go to another dr. i have not heard of a long pin like that, but i would check it out.

Debbie,
Six months ago I had surgery on the MPJ where they cleaned out the joint, straightened the large toe and shaped the area where bunions usually exist, (I had no pain there but the doc felt it needed shaved). In addition to a screw in the large toe, a pin was put in, somewhat in the shape of a golf club or a wig pin in the shape of an L instead of a T. This pin was suppose to have been seated with the club edge towards the center of my foot. Evidently the pin popped out, rolled causing the club edge to push against the inside of the foot. (When I say club edge, the shape is not that of a golf club but normal pin size...it is just the short end of the pin) Since the area was delicate from the surgery and the pin was so close to the surface of the skin, it caused pain and discomfort when something pressed against it. In time the area toughened and pain was no longer evident....even in normal shoes.

Debbie,
Six months ago I had surgery on the MPJ where they cleaned out the joint, straightened the large toe and shaped the area where bunions usually exist, (I had no pain there but the doc felt it needed shaved). In addition to a screw in the large toe, a pin was put in, somewhat in the shape of a golf club or a wig pin in the shape of an L instead of a T. This pin was suppose to have been seated with the club edge towards the center of my foot. Evidently the pin popped out, rolled causing the club edge to push against the inside of the foot. (When I say club edge, the shape is not that of a golf club but normal pin size...it is just the short end of the pin) Since the area was delicate from the surgery and the pin was so close to the surface of the skin, it caused pain and discomfort when something pressed against it. In time the area toughened and pain was no longer evident....even in normal shoes. why did you have surgery again if you were not in pain?

Lyndie and Dancing Girl, I am surprised that the pin you both have is not going to be taken out. Look, I'm no doctor. I have been through a lot with my foot and I know a lot more about podiatry than I ever thought I would, but I'm just a patient with real experience, not a medical professional. Just because I never heard of it, I only know what I went through and what I have read on the internet, which you always have to take with a grain of salt. With that being said, it does sound unusual to me (and I think Debbie too) that you both got a pin put in that was not going to be taken out. From what I understand about pins, they are temporary, they allow the bone to heal straight, but eventually come out. I would think for a fusion, a pin would be an odd choice of hardware, I think a plate across the top of the bone is a better choice. The pin is inside the bone, which just seems strange, the bone should fuse up together without needing something internal to provide strength. The bone with a plate on top will be nice and solid, I would think with a pin in the middle of the bone, that just seems strange. Maybe ask your doc exactly what the point of the pin is, what's it's function, what is it providing, how much strength is gained with it in place, can it come out?
Tweety, are you still checking this board? How are you making out, how are things going?

Hi, I went to the doctor Tuesday. Asked him again if the pin comes out and he said no, that it is embedded in the bone and no need to come out. It took a guiding wire to ensure proper placement. That guiding wire is what originally broke and he would have left it in there too but it popped through the bone and had to be retrieved through the bottom of my toe. Then they used a new wire and placed the pin.

I think with my history of not wearing shoes and banging my toe and being pretty active, he might have thought this was my best bet. My toe is healed through now but he would like it to build up a bit more along the break line. He did say I could get rid of the walking boot. He suggested BMT shoes. So I went to the shoe store and couldn't get a shoe on. I ended up buying a pair of backless Clarks shoes in size 10, usually wear an 8, in order to get it on. Guess my foot is still pretty swollen. I walk pretty slow and my ankle seems kind of weak. Also wore my daughter's Uggs to work yesterday and I could walk a little faster but I don't think they were enough support. My foot hurt a lot last night. Any suggestions as far as shoes? We had our first snow last night and don't know what I can get on my foot.

Hi, I went to the doctor Tuesday. Asked him again if the pin comes out and he said no, that it is embedded in the bone and no need to come out. It took a guiding wire to ensure proper placement. That guiding wire is what originally broke and he would have left it in there too but it popped through the bone and had to be retrieved through the bottom of my toe. Then they used a new wire and placed the pin.

I think with my history of not wearing shoes and banging my toe and being pretty active, he might have thought this was my best bet. My toe is healed through now but he would like it to build up a bit more along the break line. He did say I could get rid of the walking boot. He suggested BMT shoes. So I went to the shoe store and couldn't get a shoe on. I ended up buying a pair of backless Clarks shoes in size 10, usually wear an 8, in order to get it on. Guess my foot is still pretty swollen. I walk pretty slow and my ankle seems kind of weak. Also wore my daughter's Uggs to work yesterday and I could walk a little faster but I don't think they were enough support. My foot hurt a lot last night. Any suggestions as far as shoes? We had our first snow last night and don't know what I can get on my foot. what are bmt shoes? it sounds like you need alot of support.

Like usual I turned the letter around. They are MBTshoes (Masai Barefoot Technology). They are designed to simulate walking in sand. Just I still can't get a pair on.

Like usual I turned the letter around. They are MBTshoes (Masai Barefoot Technology). They are designed to simulate walking in sand. Just I still can't get a pair on. i never heard of those. you have to try other shoes-you need support

I cant help with information...But my prayers and thoughts are with you :). Hope you find help for your pain.
Sabrina

Hi! I'm still hobbling around. I have found a couple pairs of firm backless slip on shoes and they seem to work fairly well. My foot is still larger than the other foot and I have strange sensations through the toe and under the other toes on the bottom of my foot, but not a lot of pain any more. It actually feels better with weight on my foot. I haven't had to take anything for pain lately. I feels better than before my surgery when I try to sleep at night and feels great when I first wake up. Guess there is hope. i am banking on the doc being right when he said in 6 months I will be walking like normal. It was 3 months the other day. I had my surgery on September 7.

Lyndie, that is great news. Think about it, you are only 12 weeks removed from bone surgery and look how well you are doing. I would expect that in another 3 months, you will 2x as good as you are now. Keep taking it easy and slow, things sound like they are going well for you. What's next for you; do you see the doc anytime soon or have some PT scheduled?

Hi, dbgoalie. Thanks for the encouragement. I have started doing a little more walking at work--hurts pretty much but seems a little better. I saw the doctor last Monday, 12/17. Doc thought I should actually be healing a little better than I am. He thought that maybe circulation to that toe isn't the best and that slows healing. I told him I did have some frostbite in high school and that circulation isn't great in my toes. He is going to see me again 1/7 and do another x-ray. The other day I tried on one of regular shoes and got it on. It wasn't comfortable at all so I took off but that was a good day. Fighting snow and ice now. It makes it difficult when you cannot wear a shoe that has a back. I just stay inside as much as possible. How are you doing? Are things improving on schedule?

hi, it sounds so much better than before so stay optomistic.

Thanks for the encouragement. I have good days and bad days. I had a good day today. My limp seemed a little less. Yesterday my whole foot seemed so "out of shape." Had to exercise my ankle and flex my foot because the underside arch was feeling so tight or something. Do circles with my foot. Do you know what I mean? I so wanted to go for a walk but know I can't yet. Maybe by spring. I was pretty depressed yesterday. Monday is my next doctor's appointment and x-ray.

you will get there!

You see the doc today, right? I am hoping you get some good news, good luck. Let us know.

Really feeling bummed lately! My foot and toe have been hurting a little more lately. Saw the doc Monday. He looked at the x-ray and said it is hard to tell if the foot has a problem or isn't healing like it should be. He had me get a CT today. Now he is going to be gone the rest of this week so I won't know what it shows until sometime early next week. He thought there may be a chance he will have to go back in a second time. He hopes the CT will show that there are just spots that haven't completely healed yet. It could just be that circulation isn't the best in the joint itself so healing is slow. I'm sure not wanting to go back on crutches and having all the pain and swelling from surgery again. But it does seem to have taken a turn for the worse. Has anyone else had this problem after 4 months?

all i can say is the ct scan should show everything and you will have your answers. trust me, i know how frustrating this is. i would like to pull my hair out right now.

Lyndie, has the doctor mentioned a bone stimulator? I am currently using one, and some people feel that it can help accelerate recovery, and other people feel that your body would heal up anyway, so this machine does little. But I suppose it's worth a shot.

Sorry to hear that you aren't doing as well as you want. Remember, you are only a few months removed. It will take time, try to be patient. It could be a year or more before you are recovered. You can do it, just try to stay positive and be patient. I hope that doesn't come across as annoying, sometimes you just don't want to hear that kind of crap from people. But at least I'm not someone in perfect foot health telling you to suck it up, I know what you are going through. Hang in there.

I too am, using a bone growth stimulator after my fusion. It seems to be working well for me. Just make sure your insurance will cover it. They cost from 3,500.00 to 5,000.00, and they are for "single patient use only," as dictated by the FDA. This means that you can't rent one, it must be purchased by and for you only. Not sure why, but that is the regulation on these.

Good point Jeff. Fortunately my insurance did cover my bone stimulator, otherwise, I think I probably would have waited a few weeks to see how my fusion did healing on it's own. My doc recommended it, but in the end, I would be the one to part with a few thousand dollars, and I doubt I could have done it on my own. But anyway, they paid for it, I'm using it, and Jeff is also correct that it is to be single use only. Anyone have any idea what to do with it when I'm done? I can't sell it by law, since it's used and I'm not an FDA approved seller of medical devices. Do I give it back to the doctors office? Anyone else think it's kind of silly to have a device that costs thousands of dollars and has to be purchased individually each and every time? Can't these machines be rented and or refurbished for use?

The doctors office can't take it back, because it is a "single patient use" item. You could try and sell it on E Bay at a very discounted price. I see they are selling there for about 75.00 when I last looked. However, that too really isn't legal. Perhaps you could donate it to a charity like, I believe, "Doctors Without Boundaries." These groups privide heath care items to third world countries and such.

Also to answer your question, no they can't be rented, returned and refurbished, again because of the FDA guidelines of "single patient use" items.

Lastly you could keep it without guilt as it is legally a "one patient use" item. That way if in a year or two you'd fracture or hurt your implant, you'd have the unit to help heal.

Wow! I had no idea they were so expensive. I have one also.

mine was 5 thusand and insurance paid most of it. i didnt know what to do with i so i gave it back to my dr. maybe that was a mistake.

Still haven't heard back from the doctor on my CT from 1/9/08. He was going out of town until today. Hope to hear tomorrow. If I don't, I will be calling him. He didn't mention a bone stimulator, but thanks for the heads up on insurance maybe not paying for it. I will sure check on that if a bone stimulator is an option in my case.

Thanks for the support. I keep telling myself the same thing you guys keep telling me. That I am probably doing fine. In fact, in the hall today at work someone told me I wasn't limping as bad. So maybe it's better. The doctor originally told me I would be walking normally in 6 months and that is about two months out yet and if I look back at 2 months ago, I have come a long way.

I do have a little swelling of the big toe yet and a knot on the bottom of the toe from scar tissue where the doctor went in to retrieve the guidewire that broke out and went through the bone. I will let you know what I hear from my CT report. Thanks again everyone.

Hi

I do hope this post is still active after a few months. Isnt the internet a wonderful thing as I was surfing about hallux rigidus and came to this site. I had the fusion in the UK on the 17th December and its strange reading this site as to how different this is treated 'across the waters'.

I wasnt put on crutches and was in plaster for 6 weeks, Had the plaster off on Wednesday and it was - yuch! my toe looks so much shorter and my foot looks so - 'not like my old foot' any more.

I am now discharged from the hospital - but am not walking well, its the balance that feels strange. My hubby keeps saying stop limping!! - But that's how it is at the moment for me. The orthopaedic guy said take it easy for a month after which time -" well it could be 6 months before it returns to normal." I am disturbed that I cant use that big toe any more.

I tried to drive the car yesterday - but it was painful pressing down on that clutch as I have a manual, and am seriously thinking of an automatic.

I have early stages of hallux rigidus in my other foot and am definite that I wont go to surgery at this point in time as I didnt realise what this op entailed.

If anyone out there in cyber space reads this - well thank you and it
was good to put my feelings in writing.

Thanks and God Bless

Nan

You need to give it time. Everything got weak while you were in the cast and on crutches. Don't rush it. Things will improve, little by little, week by week.

maybe you should get an automatic. healing takes such a long time and especially the foot. try to hang in there.