Question
Dr. Tsatsos,

I have a question related to some foot pain I have been having for the last 5-7 years.  This is my right foot, and I have pain on the bottom of the foot at the apex of the arch (I have flat feet and an accessory navicular bone).  I also have pain on the ball of the same foot.  This pain used to be minimized by stretching and massage, orthotic inserts help a little bit.  I have literally tried everything the podiatrist recommended (night splints, taping, icing, massage, cortisone, N-SAIDS, courses of prednisone, rolling my foot on massage balls, rolling on cold cans, everything short of running across lava in frustration!).

So recently I went to an orthopedic surgeon.  I got xrays (all looked good) and an MRI which shows some general swelling in the painful areas and edema in the fibular sesamoid.

The doctor is recommending a Strayer procedure to relax the tendon and hopefully relieve the arch pain.  He is a bit stumped about how to relieve the sesamoid pain...but hopes the procedure will also remove some of the strain on my forefoot.  He has mentioned something about assymetry...and the podiatrist has mentioned my legs vary in length to some extent.  I am at my wits end, as the previous treatments (massage, NSAIDS, stretching) no longer work and the pain sometimes wakes me up at night, particularly if I stood a lot during the day.  Standing can be excrutiating, walking doesn't really seem to make it much worse...although the foot throbs after long walks.

So first question, does this Strayer procedure make sense?  Any other suggestions?

Second, any advice on the sesamoid issue?  Could it possibly be helped in this procedure?

Third, the doctor is concerned about Deep Vein Thrombosis as I travel extensively for work.  Is there a general guideline regarding restricting travel for a few weeks/months?  Could this be minimized by using compression stockings, exercising in flight, and by using anti-coagulants.  I know it increases risk, but time wise where does the risk descrease?

Kind regards,
Andrea

Answer
These Chicago Podiatrists,Bartlet & Elmhurst Podiatrists & South Loop Orthopedic Podiatrists say.......

Dear  Andrea,

First try a lift in the shoe of the shorter limb.If it is only half an inch difference-it's worth a try. Also have the lift put in orthotics and also have a "pocket" for the area of pressure of the sesamoid. The fact that your orthopod is not familiar with sesamoid pathology tells me to get another opinion.
A Strayer is a big procedure and does not sound like the right procedure for an accessory navicular with a collapsed arch. I would recommend another opinion or two from a Podiatrist Board Certified in Orthopedics possibly followed by a Board Certified Podiatrist in Foot & Ankle Surgery.
Hope this Helps &
Good Luck!


We also provide a service where we can review the medical records and give an opinion for a fee.
You can contact us at AnkleNFoot.com

Dr George Tsatsos & Svetlana Zats
Podiatrist Chicago 60618 & Elmhurst 60126 Podiatrists
Board Certified in Foot and Ankle Surgery & Orthopedics
New South Loop Location-Chicago 60661
AnkleNFoot.com
Runnersdoc.com
BabyFootDoc.com

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