In my Westchester Health podiatry practice, my goal is to help you achieve freedom of movement without pain. Foot and ankle pain can be especially difficult to deal with, especially since as upright humans, we spend a good majority of our lives on our feet. In fact, most people put 75,000 miles on their feet by the time they reach age 50.
Many of my patients experience foot and ankle pain but do not require surgery. As a highly experienced foot and ankle specialist, I will examine you and give you my professional opinion as to whether I think surgery of the foot or ankle is necessary—whether your condition stems from an injury, arthritis, osteoporosis, an ongoing problem or simply general wear-and-tear. If together, we determine that surgery is the best option for you, I will thoroughly explain the surgical procedure so that you fully understand what to expect.
To know whether or not your particular condition warrants surgery, I’ve put together this list of guidelines to help you assess if you are a good surgical candidate.
Your feet and ankles are very vulnerable to injury
The feet and ankles are complicated musculoskeletal structures. Because they support the weight and bear the impact of the entire weight of the body, they are easily injured. Twisting, spraining, fracturing and even breaking the foot or ankle are common injuries, caused by strenuous athletic activities, a trip or misstep, or even ill-fitting or high-heeled shoes. In addition, once any of the many ligaments and tendons in the area are damaged, they become looser and more prone to injury in the future.
Although foot and ankle injuries are common for everyone, athletes are especially prone to damage in these areas. High-impact running and jumping can pound the relatively unstable ankle joints and delicate metatarsals of the foot, making these areas more susceptible to injury.
Signs that you may need foot and/or ankle surgery
- Chronic foot and ankle pain
- Constant heel pain
- Pain with motion
- Pain that causes you to limp
- Bunion: an enlargement of the bone and tissue around the joint of the big toe
- Hammertoe: a contracture of the toe(s), frequently caused by an imbalance in the tendon or joints of the toe
- Bone spur: an overgrowth of bone as a result of pressure, trauma or stress of a ligament or tendon
- Blisters
- Corns
- Neuroma: enlargement of a nerve segment, commonly found between the 3rd and 4th toes
- Pain that flares up with vigorous activity
- Tenderness when pressure is applied to the joint
- Joint swelling, warmth and redness
- Increased pain and swelling in the morning, or after sitting or resting
- Difficulty in walking due to any of the above symptoms
Arthritis: a major cause for surgery
The 3 major types of arthritis that affect the foot and ankle and may warrant surgery are osteoarthritis, rheumatoid arthritis and posttraumatic arthritis.
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Osteoarthritis
Osteoarthritis is a common problem for many people after they reach middle age, but it can occur in younger people too. With osteoarthritis, the cartilage in the joint gradually wears away. This can result in bone rubbing on bone and often causes painful osteophytes (bone spurs). Osteoarthritis develops slowly, causing pain and stiffness that worsen over time.
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Rheumatoid arthritis
Rheumatoid arthritis is an autoimmune disease in which the immune cells attack the synovium covering the joint, causing it to swell. Over time, the synovium invades and damages the bone and cartilage, as well as the ligaments and tendons, often causing serious joint deformity and disability. The exact cause of rheumatoid arthritis is not known. Although it is not an inherited disease, researchers believe that some people have genes that make them more susceptible to it. There is usually a “trigger,” such as an infection or environmental factor, which activates the genes. When the body is exposed to this trigger, the immune system begins to produce substances that attack the joints.
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Post-traumatic arthritis
Posttraumatic arthritis can develop after an injury to the foot or ankle, and in some cases, does not show up for many years after the initial injury. Dislocations and fractures—particularly those that damage the joint surface—are the most common injuries that lead to posttraumatic arthritis. Like osteoarthritis, posttraumatic arthritis causes the cartilage between the joints to wear away.
Most common types of foot and ankle surgery
- Ankle arthroscopy/arthroscopic surgery
- Bunion surgery (bunionectomy)
- Hammer toe surgery
Benefits of foot and ankle surgery
The main advantage of foot and ankle surgery is the alleviation of pain, although there are many other benefits as well, depending on the surgery:
- Ability to walk, stand and run without pain
- Correction of deformity
- Improved quality of life, ability to return to normal activities
- Increased gait stability
- Increased mobility and movement
- Reduced foot and ankle pain
- Return to competitive sports
Foot and ankle pain is not normal and needs attention right away
Your feet and ankles should not be hurting you. If they are and you’re wondering if maybe you need surgery, or if you have any concerns about your feet, ankles or heels, please call (914) 232-1919 to make an appointment to come see me at one of my Westchester Health offices. I’ll examine your heels, ankles and feet, evaluate your condition, and together with you, determine the best course of treatment (possibly surgery) to alleviate and hopefully, eliminate your pain. Whenever, wherever you need us, we’re here for you.
By John Viscovich, DPM, MBA, FACFAS, board certified podiatrist with Westchester Health, member of Northwell Health Physician Partners