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Wednesday, October 8, 2014

Hallux Rigidus Surgery Complication: Email Advice

Hi dr blake, you were kind enough 2.5 years ago to give me good advice after my hallux rigidus surgery. I have been doing really well, though it was a long road. Been hiking and biking which I had given up. I now only wear dansko xp shoes and keen hiking boots with custom orthotics, but have started to get terrible pains in my pinky toes. It happens when I'm standing or walking - its a burning sensation, continues after I remove my shoes. My pinkies are very bunched and sort of curled - any thoughts or suggestions?

Martha (name changed)

Dr Blake's comment: 

     Martha, or whatever name you are going by today, thank you for the kind words and email. Two common problems occur following Hallux Rigidus problems with or without the surgery. They both relate to our body's natural compensatory motion of moving away from a problem. So, if the big toe joint is painful, or limited in motion, or both, we can easily supinate and roll our body weight towards the outside of the body. This shift in body weight can stress the side of the foot where the pinky toe ( #5 ) lies. The pain can be just a strain of the tissue, or the signs of a Morton's neuroma starting (especially nervy are symptoms like burning, buzzing, tingling, etc). The treatment is typically related to metatarsal supports behind the weight bearing (see posts on Morton's neuroma and padding suggestions) prominences, and/or lateral wedging to prevent over supination (and I have many posts on supination treatment). Some of this you need to sense out. Do you feel like you are rolling to the outside, etc? Kinesiotape or Rocktape can be used to stablize the outside (see the blog on arch taping with Kinesiotape as a circumference wrap). Get small Hapad longitudinal metatarsal pads at Experiment with icing twice daily, neural flossing three times daily, and Neuro-Eze (buy online). Hope this helps you moving in the right direction. Rich

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Thank you very much for leaving a comment. Due to my time restraints, some comments may not be answered.I will answer questions that I feel will help the community as a whole.. I can only answer medical questions in a general form. No specific answers can be given. Please consult a podiatrist, therapist, orthopedist, or sports medicine physician in your area for specific questions.