I have long standing diabetes with a abone spur in my big toe. It is painful to walk and Dr. said it might take a long LONG time to heal after surgery. He didn't think an orthotic would be useful. Should I get a second opinion, and are there any vitamins that might help alleviate the pain? Also, does anyone think an orthotic might help? I can't stand the thought of not being able to walk comfortably again. lbn

Hi. FINALLY, another person has the same problem I have!! I have diabete's as well, but the bone spur on my big right toe has nothing to do with the diabete's at least for me. I think this has been going on for at least 25 years or more, but only in the past 5 years did it start to hurt enough that it interferered with my ability to walk comfortable. About 2 years ago I got several opinions from 2 podiatrists and an orthopedic surgeon. They seem to feel that the removal of the bone spur wouldn't resolve the problem anad the fusion was a last resort (they fuse your toe with a pin leaving the toe unable to bend forever. (BUT HOPEFULLY THE PAIN WOULD BE DONE!!) I went for a few years and it got so bad when i walked a lot that I knew I had to do something. I went to another orthopedic surgeon than I ahd gone to before and he said that if it hurt that much I shoudl do sonmething. He said I was inbetween a bone spur and a fusion. I elected the removal of the bone spur, but unforantely 4 months later it still hurts and I am now considering the fusion. The recovedry time for the fusion surgery is significantally longer and requires a cast with no pressure for 6-8 weeks. Crutches were not easy to balance on for me! I am waiitng to hear from the surgeon who did the other surgery and have also made an appointment with the orthopedic surgeon that I had gone to a few years ago, but couldn't get an appointment till October (I think it is at the end of Oct. I am back to walking, because I have to get around by foot and public ttransportation, but some days it hurts more than others. The removal fo the bone spur gave me more mopvement in my toe, but I still have the arthritis.
If you have any queations you can post a message here and I will read it and write back. I hope this information helps.

Please, Please Foot Network experts answer my questions. I have a surgeon who I think is too busy and feels my questions not important enough to retun phone calls. He tries once and if I am not available might try once mroe and give up. He wants me to wait for a few more months after the cheilectomy I had done on May 6th, but I am finding it difficult to fathom months of walking where almowt every pressure of my toe hurts. I had hoped that this would relieve the pain when I walked, but unfourantely it hasn't and I am so fustrated!! As it has been 4 months psot op it doesn't seems to me that there is a chance it will improve any more, but I am not a medical person. I am seeing a podiatrist next Friday so I wil show him the report and ask him these questions. I knew this going into the surgery, but have been advised to wait on the fusion as it is permanant, and has a longer healing time, I just recieved the operitive notes from the hospital which I requested. I have a couple of questions from this report and also if you can answer the other reply I did at least a week ago . The report says "there was some inflamed synovium". What does that mean? It also says there was loss of cartilage in the inferior 2/3 of teh joint. Pelae let me know ASAP what you would advise at thsi time based on this and the other messages I ahve psoted.

Wow, your messages are intense,but I guess so is your pain. First of all, what treatments have your tried for the bone spur? You stated that your doctor did not feel that an orthotic would help. I would suggest that you try injection therapy, physical therapy and orthotics before jumping into surgery. If you have done all of these with no relief then maybe surgery is an option. Also, if you feel that your doctor has no time for you then find another doctor. It is that simple... you have to feel comfortable with the individual who is providing your care. The relationship between doctor and patient is two-sided. You should be able to express your concerns and if you do not feel like you are able to do so then find someone who will. I always insist on my patients asking lots of questions and letting me know how they feel about certain treatments.

Foot.com staff member

I guess u haven't read my previous messages!! I have been having pain in the great toe for years but it was been worse over the past 5 years. About 2 years ago I went to several podiatrists and an orthopedic surgon to see what would be recommended to remedy this sistuation. It was had to do much walking which I really like to do and have to to get around as I don't drive!! I would like to be able to walk without p[ain as well as cross country skii too It seemed that the fusion was the solution and wasn't rcommended so I let it go a few more years. Finally in April I saw the differnt Orthopedic Surgeonthen I saw previously who did the chillectomy (spelling) . When I saw him and he did an an exam and x-rays he said I was between that and a bone fusion. I opted for the less invasive and hoped it would work. According to the nurse practioner in my primary care office who I trust completely, her opinion is (and I think that I would agree on her analagysp?)that the surgon said that I should wait a year if the first surgery didn't work and he seems that until that time is up he doesn't want to hear from me until then. I did make an appointment wih him fo Nov 5th athough I suppose with the ice and cold it would be better to have the sugery when the weather gets warm. The dr's are busy with their practices - seeing patients,surgery and the confines of the health plans which dictate so much of what they can do. Most drs are like this about getting back to the patients and having time to answer questions. I was taking to the surgeons PA but he told me a few months ago that If I have any questions to talk to him and then I can't reach him. I am currently having the pain when I use the toe to puch off so I think that the times it doesn't seem so bad I am walking on the other toes and towards the outside of my foot which is what I did before surgery. I had stopped taking the Idrophen regularly so I am going back on to get whatever benifit I can from it. On Friday I see a podiatrist to get my toe nails cut( I am diabetic) andwill talk to him too. If you too don't want me to write on this forum and feel i am bothering you ten I will stop and never write a message again

Thank you for contacting Foot.com. Yes, an orthotic can help to alleviate the pain in your big toe especially when used with a shoe with a rocker sole. The orthotic can be designed to reduce movement at the joint where the bone spur is located and the footwear with a rocker bottom sole helps reduce stress on the big toe during push off when you walk. I would suggest seeing a podiatrist to have a custome orthotic designed and suggest appropriate footwear.

You also asked about two terms in your chart. Cartlidge is a tissue that covers the bones in a joint to help protect and cushion the area. The synovium provides nutrients to the cartilage.

Sorry for the delayed response.

Sincerely,

Suzanne Belyea, DPM, C.Ped.
Medical Director
Foot.com for your feet.

Been there, Done that (the orthotics). I have had custom made orthotics made from the Poiatrist's office for years. The rocker bottoms are expensive. They charge per shoe and I go through shoes every 6 months. The insurance wouldn't cover orthotics or rocker bottoms. Is it normal after almost 5 months to have pain every time pressure is applied to the big toe in walking? The surgeon sems to want more time to go by before I consider fusion surgery.

I would suggest having the fit of your footwear and orthotic checked. You should have both the length and width of your foot measured and you need to buy footwear that can accommodate your orthotic. You may also want to consider a shoe that is designed with a rocker bottom which would be less expensive then having the rocker sole added to your footwear. The comfort and athletic shoes on Foot.com due have a mild rocker bottom incorporated into the design. Another way to reduce movement at the joint is by placing a corboplast insert under your orthotic. This is a very strong flat plate that keeps the shoe from bending.

Dr. Suzanne Belyea, Medical Director, Foot.com

Hi Thanks again for your reply. OK, let me explain. These orthotics are made by a cerified perio .. (I forget what they are called ) in a podiatrist at Massachusetts General Hospital a top notch Harvard Unuiversityh Medical School Teaching Hospital. I go to shoe stores that specialize in hard to fit shoes and have the orthotics with me when trying on shoes. There are very few shoes that will fit me because of the width and the need for a large toe box. I am going for a consultation with an orthopediucic surgeon at Mass General October 29th and to see the surgeon who did my sufgery on Nov 5. If they both feel that having that toe fused is the only solution to the toe pain I am going ahead with it. The PA for the surgeon who did my surgery and other one I will see don't do joint replacement for someopne my age (45). I can't go on like this being limitted on walking and have pain with just about every step of the toe.