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Metatarsalgia after Morton's surgery, plus PF, and arthritic hip

Posted by Cary S. on 5/26/02 at 13:24 (085295)

For the past 51/2 years I have been struggling with foot and hip pain. It turns out that my left leg,(primary problem side) is a bit longer,(5mm) than my right. I also have some problems arthritis in my left hip. The orthpedic surgeon thinks I have old Minor Slipped Epiphysis in both hips. The femoral heads are flattened, and there is a lessening of the cartilidge in the joint space, particularly on the left hip side. About 3 years ago I had surgery for a suspected Morton's Neuroma. The Doctor also removed a fair amount of additional tissue, as he thought it was inlamed tissue, and might bring some relief, as it had one of his earlier patients. Unfortunately this operation was a mistake for me, my foot bothers me more now, in and behind the area of the surgery,(which is between the 2nd and 3rd toes on my left foot). It feels like I am walking on the 2 metetarsal heads, and that there is very little padding under the 2 heads, it is almost like I'm walking on bone. I was also having strong pain in my arch at the time of the surgery. It is not the typical PF, as I do not tend to have pain when I first stand up in the morning. The arch pain has always tended to increase progressively the longer I am on my feet, particularly when I stand still. My arch pain starts behind the arch and runs along the band towards the ball of my foot. It tends to hurt a great deal, after a while, when I am on a strong arch support, however it hurts in a different pulling sort of way without the arch support. If I haven't been wearing arch supports for a few days, usually my hip and foot bother me more and more. When I finally put the supports back in my shoes my foot and hip feel better, but only temporarily. For a short time I can almost walk normally, then the pain comes in a different way but is just as much of a problem. I end up walking very stiffly and I feel like my whole leg and foot are progressively tightening up. And my arch feels like I am standing on a hard rock. I have tried several pairs of custom and generic orthotics, and have purchased every kind of comfort, and good support oriented shoes, ultimately to no serious avail. I have tried stretching and strengthing exercises for my hip area, which interestingly does seem to help a bit temporarily with my foot and hip. It feels as though I am continually tightening up , and can't seem to stay loose. I have tried supplements, and NSAIDs, most of which make me feel poorly. Currently I am trying Boswellin, and MSM, and Flax seed oil. My current foot doctor thinks I have chronic plantar fascitis, and has prescribed a night splint, which seems to offer minimal help. We have also discussed ESWT as a possibility for the future .
I also have considerable pain in my groin, back of buttock,(sometimes lower, sometimes upper), as well as pain down the front and outside of my leg. This pain is on and off, but most every day, and seems to progress during the day. Some days sitting bothers my hip very much, usually in my buttock, and other days I can sit fairly comfortably.
Frankly I am confused about how to proceed, and with what treatment. I suspect that even though I still have some cartilidge in my hip joint, that the joint may be the underlying problem, along with the fact that my leg is slightly longer. I was also very athletic until about 8 years ago when these problems began to come up. The first doctor I saw told me that I would need to get both my hips replaced eventually, because of the Slipped Epiphysis, a diagnosis which other docs have not been completely sure of. I had come to him complaining of left knee pain. That was about 10-12 years ago. I have had an MRI of my spine which was unremarkable. I've had an MRI of my left hip, which showed degenerative arthritis as well as a small cyst in the joint.
My life has been drastically effected by the situation. I am not able to work standing except for very short periods of time, and the job which I have at a computer, depending on the day, causes me a great deal of discomfort, and I end up squirming in my seat with buttock pain. If I was sure that replacing my hip would improve things I would be at the hospital now. I am anxious much of the time, particularly when my pain is worse.
I am a medium to slim built, relatively fit 46 year old man. I still try to walk regulary, even if it causes pain. Lying down is the most comfortable position for me. My pain subsides.
Any advice from any Doctors, or anyone who thinks that they can help me, would be greatly appreciated. Maybe someone who is reading this has experieced something similar? If you are willing to offer advice by phone, e-mail me and I'll call you back, or you can call me,

Re: Metatarsalgia after Morton's surgery, plus PF, and arthritic hip

Pauline on 5/26/02 at 15:29 (085301)

Wow, you have a lot going on and it appears to involve your entire leg from hip to toe. I'm not a doctor, but since so much skeleton seem to be involved I'd probably look for a good Orthopedic Surgeon who is able to treat your entire leg from the hip down because you indicate your hip is also involved and could be some cause of your entire problem. My opinion is a new comprehensive examination possibly by a different physician, maybe one associated with a Major Medical Center. Since many of these physicians specialize in different areas you may want to begin with a general Orthopedic Surgeon who could refer you to specific speciality Orthopedic Surgeons if needed.

What ever you do don't rush into surgery without a clear knowledge of that surgery, and how it will help your situation. Let them look at your entire skeleton to determine what areas are contributing to your problems. Sometimes large medical centers are helpful because several physicians are available to work together providing help for a patient.

One thing you didn't mentioned was the use of water therapy which would allow you to do some exercise but help keep some weight off your feet. If you don't want physical therapy you could always visit a local pool.

I hope you will find your answers soon.

Re: Metatarsalgia after Morton's surgery, plus PF, and arthritic hip

Cary S. on 5/26/02 at 16:07 (085302)

Pauline: Thank you for your note. I appreciate your concern,
Best, Cary S.

Re: Metatarsalgia after Morton's surgery, plus PF, and arthritic hip

Carmen on 5/26/02 at 19:13 (085311)

I am experisnceing something similar with MANY differences of course as we are individuals. I will lend my experience and you can go with it if you choose.
I am thinking of a few things in your case and CAN relate VERY much to the multitude of problems you suffer with and in the same areas....also the unremarkable MRI and other small details. As well as not having a definite diagnosis. I URGE you to not have surgery (especially HIP replacement!!!!!!! until you have explored all of this further...much further. Questions:
1. You say the doctor doesn't think it's Psoratic arthritis..has he tested you?
2. Have you had a SED rate blood test yet???
3. What blood work have you had??
4. Are you being treated by a Pod? The one who did your surgery?
5. What are you doing NOW to treat the existing pain besides playing musical shoes? Excuse my shot at humor...but Cary...I know you are frustrated and a little humor is necessary in this type of situation! I know.
6. Your MRI was unremarkable in what way? What does it say? ANY abnormalities at all showing?
7. Do you exercise at all?

Things I am thinking of...
1. Piriformus syndrome (long shot but possible as it affects the buttocks and hips)but seperate PF problem.
2. Ischial Bursitis (questionable...with the foot involvement but not impossible)
3. Myofascial Pain Syndrome (possible from repetitive stress injury, a tramua or fall)
Couple of thoughts right off my head.
a. I wouldn't put too much thought into the food causing all this trouble. Highly unlikely....but a good diet CAN give you relief.
b. Can you get into any water exercise at all? Walking in a pool perhaps? this is good for the joints and will loosen things up a bit and increase muscle strength which is important for supporting those connective tissues around your groin, buttocks, hips and back.
c. All the supplements and alternative things you are trying can be helpful...but don't count on them for a cure.
d. Get a cushion for your chair that releases the strain on your lower back...this may relieve the buttock pressure and discomfort. Are you ergonomically correct at your desk?
e. Think about an anti depressent (natural if you need to St. Johns is good) just to get you through some of this...it WILL get you down if you continue without a diagnosis. You don't want that as it does increase pain when depression sinks in.

I am in the middle of a huge move to another state....with not a lot of time on my hands (I am moving my business and my home). BUT if you can briefly answer these questions...and let me know your input on what I have said maybe we can hammerthis out together. I will do my best to help you but keep in mind I am NOT a doctor...just a person with many issues trying not to let it get me down.
Forgive my spelling...I am trying to be clear...but fast.
Perhaps you can give me your email so we don't fill up this board. If you are interested in talking further...please let me know.

Carmen
p.s. Explore this board...it's a great support and tool for foot issues.

Re: Metatarsalgia after Morton's surgery, plus PF, and arthritic hip

Cary S. on 5/26/02 at 19:46 (085317)

Carmen: You are very nice to put the time in to make such a comprehensive reply to my posting. I would very much like to talk with you on the phone. I am happy to give you a ring, or you can call me. Please e-mail me with your #, and when is best to call. I'll send you my phone # if that works better for you.
Best of luck with your move, and thank you again for your concern!!!
Sincerely, Cary Smith
(email removed)

Re: Metatarsalgia after Morton's surgery, plus PF, and arthritic hip

Carmen on 5/27/02 at 08:17 (085334)

Just sent you an email.....

Re: Metatarsalgia after Morton's surgery, plus PF, and arthritic hip

Pauline on 5/26/02 at 15:29 (085301)

Wow, you have a lot going on and it appears to involve your entire leg from hip to toe. I'm not a doctor, but since so much skeleton seem to be involved I'd probably look for a good Orthopedic Surgeon who is able to treat your entire leg from the hip down because you indicate your hip is also involved and could be some cause of your entire problem. My opinion is a new comprehensive examination possibly by a different physician, maybe one associated with a Major Medical Center. Since many of these physicians specialize in different areas you may want to begin with a general Orthopedic Surgeon who could refer you to specific speciality Orthopedic Surgeons if needed.

What ever you do don't rush into surgery without a clear knowledge of that surgery, and how it will help your situation. Let them look at your entire skeleton to determine what areas are contributing to your problems. Sometimes large medical centers are helpful because several physicians are available to work together providing help for a patient.

One thing you didn't mentioned was the use of water therapy which would allow you to do some exercise but help keep some weight off your feet. If you don't want physical therapy you could always visit a local pool.

I hope you will find your answers soon.

Re: Metatarsalgia after Morton's surgery, plus PF, and arthritic hip

Cary S. on 5/26/02 at 16:07 (085302)

Pauline: Thank you for your note. I appreciate your concern,
Best, Cary S.

Re: Metatarsalgia after Morton's surgery, plus PF, and arthritic hip

Carmen on 5/26/02 at 19:13 (085311)

I am experisnceing something similar with MANY differences of course as we are individuals. I will lend my experience and you can go with it if you choose.
I am thinking of a few things in your case and CAN relate VERY much to the multitude of problems you suffer with and in the same areas....also the unremarkable MRI and other small details. As well as not having a definite diagnosis. I URGE you to not have surgery (especially HIP replacement!!!!!!! until you have explored all of this further...much further. Questions:
1. You say the doctor doesn't think it's Psoratic arthritis..has he tested you?
2. Have you had a SED rate blood test yet???
3. What blood work have you had??
4. Are you being treated by a Pod? The one who did your surgery?
5. What are you doing NOW to treat the existing pain besides playing musical shoes? Excuse my shot at humor...but Cary...I know you are frustrated and a little humor is necessary in this type of situation! I know.
6. Your MRI was unremarkable in what way? What does it say? ANY abnormalities at all showing?
7. Do you exercise at all?

Things I am thinking of...
1. Piriformus syndrome (long shot but possible as it affects the buttocks and hips)but seperate PF problem.
2. Ischial Bursitis (questionable...with the foot involvement but not impossible)
3. Myofascial Pain Syndrome (possible from repetitive stress injury, a tramua or fall)
Couple of thoughts right off my head.
a. I wouldn't put too much thought into the food causing all this trouble. Highly unlikely....but a good diet CAN give you relief.
b. Can you get into any water exercise at all? Walking in a pool perhaps? this is good for the joints and will loosen things up a bit and increase muscle strength which is important for supporting those connective tissues around your groin, buttocks, hips and back.
c. All the supplements and alternative things you are trying can be helpful...but don't count on them for a cure.
d. Get a cushion for your chair that releases the strain on your lower back...this may relieve the buttock pressure and discomfort. Are you ergonomically correct at your desk?
e. Think about an anti depressent (natural if you need to St. Johns is good) just to get you through some of this...it WILL get you down if you continue without a diagnosis. You don't want that as it does increase pain when depression sinks in.

I am in the middle of a huge move to another state....with not a lot of time on my hands (I am moving my business and my home). BUT if you can briefly answer these questions...and let me know your input on what I have said maybe we can hammerthis out together. I will do my best to help you but keep in mind I am NOT a doctor...just a person with many issues trying not to let it get me down.
Forgive my spelling...I am trying to be clear...but fast.
Perhaps you can give me your email so we don't fill up this board. If you are interested in talking further...please let me know.

Carmen
p.s. Explore this board...it's a great support and tool for foot issues.

Re: Metatarsalgia after Morton's surgery, plus PF, and arthritic hip

Cary S. on 5/26/02 at 19:46 (085317)

Carmen: You are very nice to put the time in to make such a comprehensive reply to my posting. I would very much like to talk with you on the phone. I am happy to give you a ring, or you can call me. Please e-mail me with your #, and when is best to call. I'll send you my phone # if that works better for you.
Best of luck with your move, and thank you again for your concern!!!
Sincerely, Cary Smith
(email removed)

Re: Metatarsalgia after Morton's surgery, plus PF, and arthritic hip

Carmen on 5/27/02 at 08:17 (085334)

Just sent you an email.....