Therapy or surgery?

by CS

I am a 48 year old female. I have had fallen arches since my teen years. For at least the past 15 years I often get a sharp pain deep inside my left ankle; there is no pattern as to when the pain occurs. The top of my feet (over the arch) also hurts at times. I sometimes get blisters beneath my toes of the left foot. This past year I have noticed that my gait is changing. I had surgery on this foot in 1998 for a painful bunion, at which time the surgeon also shortened one of my toes by removing a piece of bone.

The last podiatrist I have seen wants to perform surgery to alleviate my pain and correct some problems. He said the tendons on the inner part of my legs/feet have given out. He wants to rotate my heel to provide more arch support then at a later time deal with the foot deformities.

Bad feet run in my family. I am on my feet most of the time when I work, so I have been unable to work as often as I would like. Do you think I should try chiropractic therapy first? I think my insurance only covers 15 chiropractic appointments per year. Does the surgery seem sound? I would appreciate your input.

Hello CS,
You are asking someone with a vested interest; I'm afraid I can't promise a totally unbiased reply.

That's major surgery that's being suggested, and always no matter what the problem, a more conservative course of treatment makes sense. You've little to lose from going for the chiropractic treatment; it's most unlikely to make the condition worse and you might just get considerable relief.

I think it's important to decide up front what you would be satisfied with. With surgery or for chiropractic, for that matter. What I can tell you is that neither are likely to achieve a 100 percent cure. Would you be happy with 60% less pain?

Under the toes it sounds like you are experiencing a condition called metatarsalgia; it almost always responds well to chiropractic.

The sharp pain within the ankle joint is more complicated; it may just be a chronic subluxation in the ankle mortice or subtalar joints, both of which cause sharp stabs of pain. That responds well to chiropractic adjustments.

But you may have advanced arthritis in one or more of those joints; then it's a good deal more complicated and you may only get say 50 percent relief. Can surgery do better than that? I don't know, you'll have to ask the surgeon.

Look for a chiropractor with a FICS qualification; sports chiropractic. Your local chiropractic association may be able to guide you.

All in all a qualified yes, see a chiropractor who works daily with feet. Don't get sucked into expensive orthotics initially; and accept that 50 percent less pain is perhaps all you can expect with a long history like that. You would be able to continue with your work, whereas after major foot surgery you are looking at a layoff of several months most likely. The surgeon will tell you.

Spend some time talking to friends and family; not all chiropractors work with feet, and finding the right person is important.

Start our foot and ankle exercises which you'll find using the search function at Chiropractic Help.

I hope this contributes; let us know how you get on.

Dr B

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