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Mpls, MN, United States

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Friday, November 11, 2011

Toe

Hey, remember my bum toe? Weirdly, I don't seem to have talked about it here all that much--probably because it's too depressing. That, and before NaBloPoMo I was hardly blogging at all.

Well. It was hurting a lot: when I ran, obviously (though I was hardly doing that any more, thanks to the pain), but also when I walked, when I stood, when I woke up in the morning, at the end of the day... It hurt all the time, and the joint was red and swollen.

I saw an orthopedic surgeon, who said the only solution for me was surgery. He also said that although he would do his best to preserve the joint, if he couldn't save it, fusion would be the only option. I had to be okay with waking up from surgery with that joint fused: he didn't want any tears. Ahem. Apparently this has been a problem with former patients? I can appreciate his honesty, but I didn't love the approach.

I was pretty bummed about the surgery thing, but was in so much pain, and so much more bummed about not being able to run (the surgeon did say he had fusion patients who had run their best marathons post-surgery) that I still thought I'd have to go for it.

Before I did, though, I decided, at my dad's urging, to see a podiatrist.

Not being able to run, and being in constant pain, was making me really depressed, so it took quite a while to set that appointment up, but I finally did it.

The podiatrist was much more personable, and he told me that my hallux rigidus* was in an early stage and would likely respond well to conservative treatment--no need for surgery, at this point.

That was super encouraging! I was excited to see how the inserts he made for me, and wearing my running shoes all the time, would make my feet feel.

They made them feel a little better--but not much. So I went back, and he adjusted the inserts again. Better yet, he prescribed physical therapy, which ended up being the most effective solution to date. In addition to having the toe stretched and adjusted, and learning new exercises and stretches, I received transdermal acetic acid via iontophoresis. Although it raised tiny blisters on my skin every time we did it, it significantly reduced the pain and swelling in the joint. I was so happy to have found something that worked!

My toe got so much better that after a few weeks my PT suggested we stop and see how things went on their own. As it happened, my toe went back to bad about a week after my last acetic acid treatment. And because I was back in pain, and super bummed, it took me a long time to make another appointment (see above).

But I did. I went back to the podiatrist on October 20 and told him that even though I was wearing comfy shoes with his inserts, and wasn't even running, my foot was still driving me crazy. So he suggested a cortisone shot, which is one more thing to try before considering surgery (surgeries that he described as far more minor than what the orthopod had mentioned!).

He gave me a shot of anaesthetic on top of my foot, and then stuck a thin needle right into the joint. It did hurt, but it was over quickly, and I was able to walk right out of the office afterward. The joint, full as it was of extra fluid, felt stiff for a while, but soon felt amazing. I didn't feel any pain at all! I actually laughed out loud at myself when I realized that was because the anaesthetic was still doing its work. When that wore off, my toe hurt, worse than before. I limped around for the rest of the day.  It still hurt on the 21st, but by the 22nd, it was feeling significantly better.

Since then, it has been great! I do still feel it sometimes, especially after yoga or after a spell in non-sensible shoes. Occasionally it will pop, too, but it rarely hurts significantly. In fact, it's almost like having a normal foot again! I can hardly express how wonderful this is, and what a relief it is to not have foot pain gnawing at the back of my mind all the time. I haven't tried running on it yet, but feel very optimistic about the possibility!

It's unclear how long the shot will be effective, and he said it's not the sort of thing he generally likes to repeat. However, I've talked to people whose cortisone shots have lasted them years. I'm hoping that's the case for me, too!

Wow. That got long.


*Have I mentioned that that's my diagnosis? Latin for stiff big toe.

7 comments:

Ellen said...

Two questions: how did you get a stiff big toe? And how can I avoid getting one? I'm running now more than riding these days.

Gaggate

CëRïSë said...

The causes of hallux rigidus aren't very clear: apparently it might be hereditary, might result from a (much) earlier trauma, or might be caused by overuse. No one I've seen--chiropractor, orthopedist, podiatrist, physical therapist--has blamed it on my running per se (though running obviously means a lot more steps on the biomechanical irregularity).

I accidentally kicked a wall pretty hard when I was in 6th grade or so, but I don't even remember if it was this foot. Also, the podiatrist said he could see tendencies toward this condition in my right foot as well as my left, so it looks like I might just be predisposed toward it.

The stiffness itself had a fairly gradual onset; the toe started hurting, and then popping, before there was any loss of mobility (remember when I was ninja-taping my feet all the time?). So if you were start to have any of those symptoms, I'd suggest getting in to see someone.

Ellen said...

I'll be on the look out for ninja tapping!

CëRïSë said...

HA! I WISH one of my symptoms were actual ninja feet. I was just talking about the taping the chiropractor had been doing to provide support to my feet as ease the pain.

Ellen said...

I totally misread that, but I love the idea of ninja-tapping.

BrianV said...

"That got long".

Still, it makes some of my blogs look like one-liners.

I'm glad you're foot is better and I hope it keeps working for you!

CëRïSë said...

Ellen, I love it too!

And Brian, thanks for the good wishes! I actually did post a one-line entry yesterday... I guess it takes all types!