Foot & Ankle Center

Posts Tagged ‘ball of foot pain after bunion surgery’

Ball of Foot Pain After Bunion Surgery

Ball of Foot Pain

Ball of Foot Pain

The most common complication we see for patients who have had bunion surgery (either recently or years past) is pain under the 2nd metatarsal head.  Sometimes there is a callus present here and sometimes not.  Regardless of the presence of a callus, pain in this area is extremely common after having bunion surgery.

The reason for this is quite simple.  When performing a bunion surgery, the first metatarsal bone is usually cut in order to realign it.  Whenever bone is cut it will usually end up healing slightly shorter than it was before the surgery.  When the first metatarsal bone is cut, the following happens:

1.  A shorter first metatarsal bone bears less weight and pressure

2.  With the first metatarsal bearing less weight, the 2nd metatarsal must bear additional pressure and weight

3.  The extra pressure causes pain and inflammation of the 2nd metatarsal head.

So it is almost inevitable that those that have bunion surgery will end up with 2nd metatarsal pain at one point or another.  What we find frustrating is that many bunion surgeons don’t prepare their patients for this ahead of time.

2nd met pressure

Without orthotic: Red shows pressure under 2nd metatatarsal

Luckily this is a problem that almost always responds quickly to conservative treatment.   Since the problem is too much pressure on the 2nd metatarsal head, the solution is to reduce this pressure.  There are several ways to reduce pressure on the metatarsal.  The most effective method is to use a custom orthotic that conforms extremely close to the arch of the foot.  This type of orthotic, called a “total contact orthotic” has been shown in multiple studies to be the most effective method to reduce pressure under the ball of the foot (list of articles available on this page).

I had a patient in the office today who had this problem.  She was already wearing

with orthotic less pressure

With Orthotic: Decreased pressure

orthotics made by her chiropractor.  Unfortunately, as we see all too often, the orthotics did not come close to conforming to the arch of her foot.   Thus, they had no ability to transfer pressure off of the ball of her foot.   This is one more reason why, if you are going to get custom orthotics, get them only from a practitioner who specializes in the foot and in orthotic therapy.

If you are considering bunion surgery, before surgery ask your surgeon about orthotics after surgery.   If they do not understand the benefits of orthotics post-surgery, then you may want to consider a different surgeon.   If you have already had bunion surgery and have pain under the ball of the foot, then see a podiatrist who specializes in orthotic therapy.  In the Seattle area you can make an appointment for an evaluation in our office.   If you don’t have access to an orthotic expert, try these home treatment hints.

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