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chronic pain after midfoot fusion

Discussion in 'Ask your questions here' started by Unregistered, May 13, 2009.

  1. Unregistered

    Unregistered Guest


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    Hi. I had a lisfranc fracture (fractures of 2nd, 3rd, 4th metatasals, cuboid fracture) and subsequently had a midfoot fusion, 7 screws. Screws were removed about a year later due to continued pain. I continue to have pain on the top of my foot like a bruise, pain along great toe metatarsal, no feeling 4th toe going up foot, charley horses in 3rd toe pulling it toward 4th toe, significant pain standing or walking for any length of time. What could be the lingering problem(s)? Is this normal in recovery process?
     
  2. FootDoc

    FootDoc New Member

    DISCLAIMER:
    THE FOLLOWING IS OFFERED GRATIS AS GENERAL INFORMATION ONLY, AND, AS SUCH, MAY NOT BE APPLICABLE TO THE SPECIFIC QUESTIONER AND/OR HIS/HER PROBLEM. IT IS CLEARLY NOT BASED ON ACTUAL KNOWLEDGE AND/OR EXAMINATION OF THE QUESTIONER OR HIS/HER MEDICAL HISTORY, AND IT CAN NOT AND SHOULD NOT BE RELIED UPON AS DEFINITIVE MEDICAL OPINION OR ADVICE. ONLY THROUGH HANDS-ON PHYSICAL CONTACT WITH THE ACTUAL PATIENT CAN ACCURATE MEDICAL DIAGNOSIS BE ESTABLISHED AND SPECIFIC ADVICE BE GIVEN. NO DOCTOR/PATIENT RELATIONSHIP IS CREATED OR ESTABLISHED OR MAY BE INFERRED. THE QUESTIONER AND/OR READER IS INSTRUCTED TO CONSULT HIS OR HER OWN DOCTOR BEFORE PROCEEDING WITH ANY SUGGESTIONS CONTAINED HEREIN, AND TO ACT ONLY UPON HIS/HER OWN DOCTOR’S ORDERS AND RECOMMENDATIONS. BY THE READING OF MY POSTING WHICH FOLLOWS, THE READER STIPULATES AND CONFIRMS THAT HE/SHE FULLY UNDERSTANDS THIS DISCLAIMER AND HOLDS HARMLESS THIS WRITER. IF THIS IS NOT FULLY AGREEABLE TO YOU, THE READER, AND/OR YOU HAVE NOT ATTAINED THE AGE OF 18 YEARS, YOU HEREBY ARE ADMONISHED TO READ NO FURTHER.
    ***********************************************************
    There is no way that anyone without intimate knowledge of exactly what was done could opine as to what might be causing your problems, but when a permanent joint fusion is required anywhere in the foot there is always the potential . . even the likelihood of problems associated with inability of the joint to function normally. Fusions are salvage type procedures which are rarely without some adverse consequences, the advisability of which must be judged as a trade-off for what is or might be without it. You need to speak with your surgeon to determine if your present status is to be expected and if anything more can reasonably be done to mitigate it.
     
    Last edited: May 14, 2009
  3. Unregistered

    Unregistered Guest

    I know what you are going through. I am 4.5 years post op Lisfranc Fracture and live with chronic pain of 6 - 7.. I had fracture of 1st, 2nd, and 3rd metatarsals, complete dislocation of midfoot, joints removed, and complete fusion/fixation. Also total repair of torn ligaments, rebuilding of arch and now have a deformed foot. I suffer with feels like charlie horses in 1st and 3rd toe and arch. I cannot walk without a cane and after 30 - 60 minutes on my feet I am in pain level of 7 - 8. I live on oxycodone to cope with the pain. I am considering below the knee amputation and using prosthetic. I used to be very active and am now a couch potato because of the excruciating pain. I want a better quality of life, I want to work and walk without pain with every step. A.J. skymail53atyahoodotcom
     
  4. Unregistered

    Unregistered Guest

    i no how you feel i am in torcher after midfoot fusion and i have begged my doctor to put me forward to a surgen to cut it off as no body knows why i am in so much pain
     
  5. Unregistered

    Unregistered Guest

    I was injured 2 years ago in a car wreck and my right foot and ankle was crushed and almost ripped off. The initial surgery to repair the trauma involved removing many pieces of bone and putting a plate and 4 screws in my ankle,a external fixature for 3 months. After the external fixature was removed it was a slow healing process and it was 6 months before I could take a step,weight bearing.Every step was very painful. So I went to see a foot surgean he recommended a mid-foot fusion for what he referred to as the worst lis franc fracture he has seen. I was on pain medication throughout all of this. I had the mid-foot fusion and received 13 screws in the top of my foot joining all 5 toes to the joints but also joining bone to bone. My x-ray looks like a cluster of 13 screws criss crossing each other right below the toes. I also recieved bone marrow. My problem is that it has only been 2 years since this all started and I have been taken off of all narcotic pain relievers. I understand that they are addicting but I have legitamite pain it is real. I have been to several doctors but all I get is the lecture about the pain pill epidemic in southern ohio. I am not part of the epidemic im in real pain. The mid-foot fusion was supposed to make me walk without extreme pain but it did'nt work. I dont think I can live like this any suggestions on what I should do?
     
  6. Unregistered

    Unregistered Guest

    My husband has had foot pain since getting run over 16 yrs ago (fractured cuboid and ligament damage), but his doctors told him that the fusion would not work and neither would an extremen solution like amputation because his brain is so accustom to the pain that it would not go away.

    He is now disabled, in constant pain, takes meds and uses patches, and nothing works. He can't sleep and has become withdrawn, yet worker's comp won't let him see a specialist. He has tried the shots in his back, the shock treatment thing and nothing has helped with the pain. Sorry to be a nay sayer, but this is our experience to date.

    If you know of anything that might work - please post.



     
  7. Unregistered

    Unregistered Guest

    Having a long history of arthritic problems, and many, many surgeries, including ones that failed, I offer this humble advice: If you feel as if you are not getting relief for your pain, or a solution to your situation, do not wallow in it... look for another doctor! That is not to say that you should run around changing doctors every time you hear something you don't want or like to hear. But when you feel that the person who has been treating you has reacheed the end of his or her abilities to help you, then it is time to move on. At that point, search for someone who can really help you. Make sure of their qualifications. Check online feedback sites. And above all, hang in there and don't get discouraged. Look at all of us out here. You are not alone!
     
    rosette111 likes this.
  8. Unregistered

    Unregistered Guest

    Chronic pain in midfeet

    I've lived with chronic pain in my feet since birth. The bones in my feet did not grow properly due to deformity and hence as an adult I suffer much worse pain. I've tried narcotics, standard arthritis medicine, oils, hot/cold wraps, tension socks and as of late I wrap my feet in electrical tape over my sock to create even further compression. I am an active person but ultimately I pay for each step I take. For the past three weeks I have taken a drug called Meloxicam. This drug "for me" has been amazing. There are periods within the day that could last for a few hours that my pain is reduced to a level 2-3. This is something I haven't experienced in over 25 years. I was rejected for Toradol shots as my physician believed the side effects were not worth the risk. Meloxicam "for me" has not dulled my senses or created adverse reactions in the short time I have taken it. I knew within 3 hours that it worked. I don't know if any of this information is helpful or if anyone will eventually read this, but if I can help one person to live life more comfortably then my response was worth it.
     
  9. tam

    tam Guest

    Lisfranc & Fracture Arthrodesis Pain

    Wow! I wish it hadn't been so long since all of the previous posts had been posted. I see someone has posted as late as a couple days ago, so maybe we can get this thread going again! January 26, 2011, I slid in sock feet in a sloped driveway, and my left foot bend underneath itself and was literally bent in half - (toes underneath toward heel). This resulted in several compound fractures - 2nd, 3rd, and 4th metatarsal fractures at the midfoot joint, a cuboid fracture, as well as a severe Lisfranc injury. I had surgery a couple weeks later after swelling was down enough. Apparently, the surgery was not adequate for the type of injury. My hardware was backing out on its own, and had to be removed. Then my foot "fell apart". Everything was shifting and moving apart and the fracturese had not even healed after everything I'd gone through. My foot was full of arthritis also.

    I was referred by someone to Dr. Mark Myerson, in Baltimore, for an arthrodesis. He is deemed to be the top foot and ankle surgeon in the world - yes, the world. He works out of Mercy Hospital & I believe Johns Hopkins. I had mine at Mercy. You can stay at the beautiful hotel (Tremont?) across the street for a fraction of the cost if you are having anything done at the hospital. His fees and the hospital fees were about 1/4 of what I was charged for my initial surgery in San Antonio. Unbelievable. And ... he did it right this time. I have a 4-point plate with screws going through my 2nd and 3rd metatarsals and my midfoot, as well as 3 screws going through the 1st and 2nd area to correct the Lisfranc separation. I also had a teaspoon of bone graft taken off the upper part of my heel bone and put into all the fractures to help them grow back together better. He also removed all of the arthritis. He said his surgery is 93% successful and that someday I should be able to walk 5 miles again. Hmmmm - don't know about the 5 miles.

    Long story short (sorry - I know that wasn't short) - My arthrodesis was done September 13, 2011, so 6 months ago, and I still have issues. I run the gambit of pain, tightness, and swelling, but I don't think I'm nearly as bad as some of what you guys have written. My 3rd toe has no ability to work. I can feel it if I pinch it or touch it, but it doesn't "work" if I try to raise my toes up. It lags behind! Now my 2nd toe is starting to "turn" or just kind of point in the direction of the big toe instead of going out straight. If I walk in tennis shoes with an arch support, I am pretty good. Walking around barefoot is awful on hard surfaces, but walking on carpet is good. I have scar adhesion that I work on nearly every day but it seems to be an issue no matter what. I have 6 scars, 1 about 4 inches long, 1 that is 2 inches long, and 4 small scars that look like crosses. I want to say...I NEVER have pain just "sitting there." I have to be walking for quite a while or standing for quite a while or trying to walk "correctly" before I have pain, but it is still annoying.

    I REALLY thought I'd be normal by now. I talked to my surgeon's office not that long ago and they told me that it takes 6-12 months to reach "maximum medical improvement" and that all of my pain and problems I feel are probably related to "walking on a new foot," (since this just simply ISN'T the foot you were born with!). I keep having x-rays thinking something must be wrong, but nothing is wrong. Everything is healed.

    I am beginning to think I will have some sort of issue for the rest of my life. My biggest concern is future collapse. I would recommend always wearing a good tennis shoe that has a pretty stiff inside sole, with an arch support insert - even just one from the store. My cushy Reebok tennis shoes with a lot of "bounce" in them allow too much flexion. My stiffer-bottomed ones are much more supportive (Avia and Sketchers) and feel more like the bottom of a walking boot on your foot. They seem to "hold everything together" better.

    When I walk on hard surfaces barefooted, I also have pain in the ball of my foot right below my big toe. It feels like there is a golf ball in there and that I'm trying to walk on the golf ball! Weird! HOWEVER, it isn't swollen, isn't any bigger than the other side or anything. When I rock it on the floor I can hear kind of a grindy sound. It almost sounds like tendons or ligaments rocking across the bone.

    Anyway - Mainly I just wanted to say we are out here and I can totally see now after a year and 2 months of this that my life will NEVER be the same. My dog took off the other day, and I took two running steps (forgetting about my foot for 1 second) and it hurt and I realized that I was never going to be able to run again. I can't walk on grassy surfaces because the ground is so unbelievably uneven. You DO NOT KNOW THAT until you have a problem with your foot! You would think the ground is pretty even. I can feel every single solitary shift in the soil and if I step on it just wrong, it tweaks my foot and it hurts. I am scared to death of falling again so I walk so gingerly. Going down stairs is still a little hard, and I also get off balance a lot. I still limp when it doesn't matter, but I can "fake it" and take the pain for a job interview or a short-term function and people that don't know don't know. It is just hard and scary to walk and roll your foot up over that first metatarsal the way you are supposed to instead of letting more of your weight go to the outside of your foot.

    I think we have to accept that we will never be the same. It is a devastating injury that no one will ever ever understand unless you have it. Funny thing - I had never had a broken bone until these at the age of 51....and boy did I do it up right.

    If nothing else - I wanted to pass along Dr. Myerson's name to anyone out there having trouble. He is truly a genius in his field, writes medical school text books, and isn't getting any younger, so if you feel you need a revision or want a second opinion, he will evaluate your x-rays or CTs or MRIs by long distance and call you personally and tell you what he can do to help you...if anything. He didn't charge me for that evaluation and phone consultation. If you do need to go there, it is worth the plane ticket. I flew in one morning for my pre-op visit that afternoon, surgery the next morning, was on a plane back home the next day. Shuttled back and forth to airport from the hotel. And I think he takes nearly all insurances known to mankind. If he took mine (a weird COBRA plan) then he will take anything.

    I just seem to be in much better shape than some of you, and I had "the second worst set of injuries a person could ever have on their foot" - according to several doctors. So, call Dr. Myerson or get referred or something if you need help! Like I said, I'll never be the same, but I doubt I will ever need an amputation either!

    Take care! (Oh - and anyone who has had the "golf ball" in the ball of their foot under their first toe and who KNOWS what is causing this - I would LOVE to know. The doctors and nurses don't seem to know.)
     
  10. Ladykanner

    Ladykanner New Member

    Wow! So sorry to hear about the seriousness of your injury. Makes me appreciate the extent of mine that it is not as bad. I have a collapsed arch. They're going to do a talonavicular fusion and lengthen my achilles tendon when I go in for surgery on April 20th. I have been dealing with my pain since last June and quite frankly am fit to be tied. I am only 32 years old and it is consuming my life. My doctor tried everything under the sun before going towards surgery. Even referred me to see one of the other doctors in his practice for his opinion on my situation. He did a couple of different tests and said he too thought surgery was my only option. As the surgery comes closer, I haven't had any cortisone or anything in quite some time and boy can I tell. I didn't think it was doing anything for me at the time but I notice now that I haven't had any. Thank you for your post and story.
     
  11. still_standing

    still_standing New Member

    Hello everyone. I commiserate, sympathize, and identify with all of you. I have had knee surgeries up the wazoo, including knee replacements. I've also had rotator cuff shoulder surgeries. As painful as some of the procedures have been, nothing compares to the sorts of foot issues that we all deal with. People don't realize how critical it is to have healthy, well-functioning feet until something happens.

    I have had problems with my right foot for well over 15 years. I saw DPMs, rheumatologists, orthopedic specialists, and pain specialists. I've been given cortisone injections, epidurals, special shoe inserts, and special shoes. It took all that time for someone to finally identify that my arthritis had developed into fractures across my foot and a bunion of the first toe. I walked as best I could on this bad foot for several years until I could barely walk at all. I also developed a bump on the bottom of my foot caused by my body's attempts at healing my foot. When I finally had surgery in October of 2010, it was for a midfoot arthrodesis.

    Without getting into all the details, after 3 months non-weight bearing (NWB) and gradual weight-bearing in a boot and then orthotic shoe with 3 months of PT, the hardware failed, my arch collapsed again, and the surgery had to be repeated along with achilles-lengthening in May 2011. This time it was 4 months NWB and more gradual weight-bearing. I only finished my PT a few weeks ago. I have never been without pain. I try not to take anything stronger than Tylenol to supplement the Mobic (meloxicam) I take, but there are times when I can't function without using some Vicodin.

    I still have the bump on the bottom of my foot, pain - although less than pre-surgery - across the top of my foot, and am hampered with tendonitis along my heel, and on top and along outer part of my foot. I also have plantar facia. My left foot is showing signs of the same time of advancing degenerative arthritis that was present in my right foot at the beginning of all of this. There does not seem to be an explanation for why this has happened. I don't have osteoporosis, but I now heal slowly. I am not diabetic, and yet I essentially have Charot's foot. I used to be very athletic, and now it is difficult to walk any distance. I am 59 years old, live alone, and am looking at a bleak future in terms of my mobility. I worry about how I will function in the future. I don't want to become dependent, and yet it is becoming increasingly clear that no matter what I wish for, no matter what I do, I will never recover from these foot issues.

    But can I make my quality of life better than it currently is? I think so. After having been a virtual shut-in for the past two years, I am finding new interests to throw myself into, meeting new people, and starting to feed my spirit again. I guess what I am saying is, as uncomfortable as these injuries are, and as life-changing as they can be, we can still keep moving forward in life. Cancer kills. Foot problems do not. Life goes on. And when we hit a roadblock, or have a bad day, we look to each other for solace and support. Then we move forward again.

    Thank you to everyone for your posts. Your comments, concerns, ongoing experiences and supportive posts all help each of us to heal in different ways.
     
  12. Unregistered

    Unregistered Guest

    Re: Lisfranc & Fracture Arthrodesis Pain

    I have the same golf ball under my foot after fushion, just went to the doctor it is the bones under the big toe. They can be removed with no ill effects, I am going to have this done.
     
  13. Unregistered

    Unregistered Guest

    I injured myself in 2/2006 by falling down bleachers, all five metatarsals involved, I have been misdiagnosed, failed fusions, family that has no clue why my simple "foot sprain" keeps me from walking a nice country wooded trail, or causes chronic pain. I am a week out from surgery six, 10 if you count indirect. Would not be here today if I did not have 3 of the worlds most amazing kids. My husband hates me. My other family I rarely see. I kill myself trying to work pt only to go home exhausted and straight to sleep. Making me feel like a failure as I am too weak and tired to Do housework or help my kids or play sports with them.

    Used to be a stay home mom and did everything for my family, now I have the worst pain I am total failure and feel if I did not injure myself I would be in such a better place.

    I feel I need to have hope that this last surgery will help take away some of my pain so I can get my life I lost back!!!

    This injury sucks
     
  14. Unregistered

    Unregistered Guest

    I have been reading everyones post past and present looking for answers or help. I had right foot tarsal joint fusion Nov.16th 2012 Was told by doctor to start walking in regular shoe not boot for last week or so. But it is so painful to walk with regular shoe now. Its very painful stings burns feels like something is cutting me inside my foot kind of hard to explain. Doc said fusion took only thing was last visit xrays showed bone has loosened from screw little. I am searching for answers. Will I always be in pain now, If this is how its going to be take screw back out or something. I stand on my feet all day on asslembly line. I can't work like this I can't walk 5 mins how will I do 9 hours. Please help if u have any answers or advice. Thank u.
     
  15. Hi there, I have a question about the surgery you had. I have major bunions on both my feet but the one on the left is the worst and I am going in for surgery on March 8, by the way I am from BC in Canada. My ortho says I require a midfoot fusion. I know with the lisfranc fracture surgery it requires fusing and such, what I am curious about is the surgical length of time approximately. Any help?
     
  16. Unregistered

    Unregistered Guest

    Of course not, the most important thing you have to do is see a doctor. There are chronic pain treatment you can consider but first let the specialist do the check up.
     
  17. Unregistered

    Unregistered Guest

    Has anyone had hair grow next to the fusion site on the foot? I never had hair at all in my foot but short, dark hairs are growing from joint if second metatarsal right up to the big toe. I tried plucking them as the area is completely numb, but just got a sharp pain like an electric shock. Has anyone else had this?
     
  18. Wow. Reading all these posts have frightened me to no end. I had lisfranc arthodesis midfoot surgery on my right foot on April 23rd 2013 and at 9 weeks out of surgery I am still experiencing pain, stinging, burning, tightness, swelling, no feeling in 3 middle toes, big toe feels like it is pulling upward, at the bottom by arch of foot I swear there feels like something pushing out the bottom of my foot, and numbness. At my post-op check ups the x-rays show no shifting of any plates (2) or the 7 screws. The doctor says that the swelling often makes the foot feel like there is something poking out and not to worry about it. I have been non weight bearing this whole time and has been difficult on my 2 small children who are 5 and 3. I am 38 years old and unable to do anything at this time and feel useless. I knew there was going to be pain when I decided to go ahead with this surgery but never dreamed it would be this severe. The only comfort that I have had through this is ice. My ice bag has become a really close friend, I even ask for it as I need my friend. My son chuckles which helps me deal with the pain somewhat. I cry myself to sleep most nights. I am so tired of elevating and having to remain in bed mostly. I have oftened begged my family to just cut it off. I was very happy at 3 weeks when I finally got the 60 stitches out. I have to wear a dreaded boot that irritates me to no end. On July 1st the doctor is going to have me try to take a few steps and honestly I am petrified. I am so afraid of the what ifs. What if a screw comes out the bottom of my foot or what if I fall and this surgery would have been for nothing or what if I can not walk, or will there always be pain for the rest of my life? These are scary things to think about. I really wish I had researched this more before going through with the surgery. I know it was the very last resort to correcting 3 breaks in my bone from a childhood injury but at least I could walk and grit my teeth as the pain was getting unbearable but nothing compared to the pain and misery I have endured the last 9 weeks. My suggestion to anyone who is considering having surgery make sure you have all the facts before going through with it. I did not realize that I was going to be so miserable. I am just happy to know that soon I will hopefully be able to walk and at least start getting my life back. I miss taking care of my children and my husband. I am thankful that my mother has been here everyday to care for us and I thank God for my hubby who has gone above and beyond the normal routine to make me feel somewhat comfortable. God Bless anyone of you who have to go through this or any other similar surgery.
     
  19. Unregistered

    Unregistered Guest

    What a great thread to stumble upon. While I hate that you all are having chronic pain, I am in the same boat and selfishly am glad I am not alone. My Lisfranc life began an 1st 2012 after a bad fall. I knew right away something was wrong with my foot. I had 2 screws put in and was told they would be permanent. A year later I had to have a fusion done and 3 screws added, I could not heel raise without pain so walking was difficult and my back was really suffering. I needed an injection in the spine. I am now 9 months post fusion and approaching 2 years post orif and I still have pain, I am going in to have my hardware removed Sept 19th. I am hoping this will get rid of the pinching feeling I have. I cannot heel raise still and cannot push off during walking so I limp. I am tired, I cannot walk more than 2 min without stopping and I still have a good amount of swelling. I hate that I have to heal another surgical procedure. I am also having a lot of difficulty with calf tightness and 2 doctors have said they think I should have the fascia cut to release the muscle and another said it was my Achilles tendon and that it now needs lengthened. I have heard of massage that releases the muscle but my PT does not do any hands on work. Kaiser. I need to look elswhere. I do not want a 4th procedure. I am so over this injury.
     
  20. rothane

    rothane New Member

    Wow. After reading all this, I am glad I have a conservative orthopedist. My lis franc injury occurred 1/31/2010 and went misdiagnosed until mid July. At the time, my weight bearing X-rays showed my injury was right on the cusp, bad enough that I might require surgery, but not so bad that he actually recommended we try to rehab without first. He said he preferred not to cut into otherwise healthy tissue if he didn't have to.

    By summer 2011, we re-evaluated. It had not healed completely, and probably never will, but he was still satisfied that not doing surgery was the right answer. I basically have a lifelong prohibition against running and all other high impact exercise, but I can walk fine. I even went on to lose nearly 50 pounds and got down to a healthy weight, which I have been maintaining successfully since February 2012.

    I still have stiffness, pain, and occasional "snaps" inside my foot. I have to tie my shoelaces on my left foot with gap lacing to remove pressure from my mid foot. Forget high heels, ever. There is permanent nerve damage from six months of misdiagnosis and improper treatment. But all told, it could be far worse, and I a still glad I never had surgery. I walk five to seven miles a day, between planned exercise and outdoor intensive hobbies. There is life after lis franc!
     
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