Stepping Out

So for the last couple of years, both of my great toes have been painful, in different ways, and in different spots, but nonetheless, restricting my ability to walk as long and often as I would like.

As a backdrop to this, I had major foot reconstructive surgery done in 2012 (right foot) and 2013 (left foot) that was life changing and very successful, leaving with me with fused joints and screws in the joints.  I remain highly satisfied with the results but wanted to revisit my foot surgeon and get his take on the current pain situation.

Caring for your feet

I need to back up to explain how this happened.  Last summer and early fall when the discomfort had escalated, I decided to see a local podiatrist to see if she could work on the very heavy calluses that were on the great toes.  I get pedicures regularly and the gal that does them does a wonderful job of shaving them, but I thought I would check in with a podiatrist to see if she could do anything more and/or had any other ideas.  My first mistake was that I did not consult my rheumatologist prior to that visit, because as it turns out, he would have provided me with the knowledge I needed without seeing her.  My second mistake was allowing her to talk me into orthotics.  It took 4 retries and still they are not right, making them 100% useless to me, $500 later.  Which brings me to my visit last week with my foot surgeon.

She had told me I had a bone spur under my toe nail that was creating the swelling and pain below, in and around the nail on my left foot.  Turns out the x-rays done last week show this to be completely false.  I was relieved to hear that, but still needed to know what was causing the pain.

Turns out I have arthritis in both toes!  Surprise, surprise.  I almost laughed when my doctor told me this.  He said the x-rays clearly show some arthritis.  Apparently, one of the results of the surgeries is that my gait is quite different because I no longer have flexion in my foot and also little to no arch.  Therefore, my weight is almost entirely carried on my great toes.  This not only explains the pain but also the calluses.  Makes sense.  Now what?  Well now we get to the point of this article.

The doctor spoke such common sense to me I was very appreciative!  He said, “Nan there is nothing surgically or treatment wise we can do.  Our goal is to give you comfort, and feet that are not painful.”  He then offered some suggestions for shoes and sandals with larger and more rigid toe boxes.  He said to keep getting pedicures, be kind to my feet and wished me the best.

Now it may sound odd that this completely satisfied me, but the fact is having someone be completely honest and give me simple, effective advice was awesome.  Far too often, it seems like we encounter medical folks who reach for reasons, for surgical answers, elaborate treatment choices (like $500 orthotics), all with good intentions, but, the fact is, it is likely unnecessary at best, and detrimental at worst.  I think we face this dilemma quite often in our attempts to treat our RA.  The key is to make sure whatever choice we make, we do it with solid medical opinion(s) to support our choices.  I was 100% certain before my foot surgeries and could not be more satisfied with the results.  This little bump in the road is part of aging and life in general and knowing that, makes it just fine.

Nan