Metatarsalgia Surgery

The total recovery time ranges between 3, 6 and 12 months, depending on the conditions and the recovery rate of each patient. Recovery is one of the most important moments of the process. A good part of the success of metatarsalgia surgery depends on following the relevant indications for each stage of recovery.

It is estimated that around 10% of the world’s population suffers from metatarsalgia, and that 80% of the total population may experience metatarsalgia symptoms at some point in their lives. Statistics show that 88.5% of people with metatarsalgia are adult women. The factors that most influence this population group are usually the frequent use of high-heeled footwear, which creates biomechanical alterations in the foot. Keeping the foot in the so-called “equine position” (resting on the metatarsus), unbalances the distribution of the body’s overload, and exerts greater pressure on the metatarsals. Metatarsalgia is also due to a certain genetic predisposition, but this cause is much less frequent than the use of inappropriate footwear.

There are some methods that we can put into practice at home to improve the symptoms of metatarsalgia. Some of the most common methods are:

• Put ice on the painful area : Ice is convenient to relieve pain and inflammation. An ice pack should be applied where the foot is most painful. From 2 to 3 times a day you can put an ice pack between 15 and 20 minutes. You can massage the area with ice, or place your foot on it. It is more advisable to apply ice at night, when the foot is going to remain at rest. This method is not recommended for people who have circulation or sensitivity problems.
• Decrease the number of activities : Foot rest is a good way to avoid the aches and pains of metatarsalgia. Likewise, some positions should be avoided, such as squatting, standing on tiptoes, walking downhill or wearing high heels that keep the foot in an equine position.
• Avoid high-impact exercises : To prevent pain from worsening, it is recommended to stop doing high-impact exercises, that is, those that demand a lot of strength and are very intense, such as: running, playing soccer, lifting weights, etc. It is better to do low-impact exercises, such as swimming, bicycling or running in the pool.
• Immobilize the foot : The doctor can teach the patient some splinting or padding techniques, so that the foot can be immobilized at home for as long as he wants, without having to go to the clinic for it. This immobilization can be done for a full day, or for a few hours.
• Practice stretching exercises : Stretching exercises for the calf muscles can be done every day at home. At least 2 times a day, repetitions of 30 to 60 seconds can be done for each foot. The exercise consists of standing in front of the wall supporting both palms of the hands perpendicularly against the wall. Then you have to bend one leg forward, while the other remains stretched behind. In this way, swing the body forward as much as possible without separating the soles of the feet from the ground. When the patient feels the tension in the calf of the foot that has been left behind, they should hold the position for 30 to 60 seconds, before moving to the other foot to do the same.

For metatarsalgia surgery, local anesthesia is used, which may be accompanied by sedation under the control of an anesthetist. Usually the foot remains asleep for a period of 4 to 6 hours. This gives the perfect period of time to perform the metatarsalgia surgery without the danger of the effect of anesthesia wearing off, and to avoid pain for a while.

After the first 2 days, or in some cases after a week after metatarsalgia surgery, patients are recommended to start washing the wound. Performing foot baths with saline solutions in warm water every day will be very useful.

To prepare this solution, water must be boiled and allowed to cool in the container where the foot will be placed. You have to wait for the water to reach a temperature that allows you to insert your hand without hurting yourself. That’s the time to add a tablespoon or two of common salt. The foot should not be soaked for more than 5 minutes in this saline solution. If there are pieces of bandage stuck to the wound, they should be allowed to get wet and fall off on their own. When finished, the foot can be bandaged with thin gauze or left in the open air.

When the person goes to the consultation for the first time, the doctor will ask several questions, with the aim of knowing the history of the possible patient. The person should express as clearly as possible the symptoms they feel when walking or doing other activities. You must also say if you have any disease. Then the doctor will do an examination of the foot, which includes both tests to determine the real mobility of the foot, as well as palpate the affected areas to recognize them. Finally he will indicate some x-rays. Then you can issue an accurate diagnosis of the causes of metatarsalgia and possible solutions, whether non-surgical or surgical.

Patients who have a type of work that does not require much physical effort can begin their activities between the fourth and sixth week of recovery, while always keeping the foot as carefully as possible. On the other hand, patients who have a heavier job that requires more physical effort must wait until the sixth or eighth week to return to work.

After metatarsalgia surgery, patients will be able to return to so-called “low impact” exercises after the third week of recovery. Riding a bicycle or exercising in the pool are optimal exercises for this stage. High-impact exercises and sports, which include jumping, running, or doing a lot of physical effort, can begin to be practiced from the third or fourth month. But if the patient is still not completely recovered, he must wait until the sixth month to carry out these practices. Before beginning any physical practice, you must ask the opinion of the surgeon.

After the sixth or eighth week of recovery, metatarsalgia surgery patients may be ready to drive. Although the foot may still be inflamed, normal footwear can now be used (if it fits), and the person will have enough strength to perform the maneuvers on the car pedals. However, we recommend that the patient consult with their surgeon before starting to drive. There are people who need to wait a little longer before driving, and complying with that may depend on the smooth recovery. In addition, it is convenient to ask the car insurance about the basic conditions that people who have recently had foot surgery must meet to maintain coverage.

In the event of any unusual signs, patients should immediately contact their surgeon. Some of the symptoms that recovery after metatarsalgia surgery is not going well are the following:

• Swelling beyond normal.
• Purple and red foot.
• Itching and burning in the wound area.
• Release of pus or blood that wets the bandages.
• Continuous fever that does not go down.
• Signs of bad odor in the surgery area.

Statistics show a 75% success rate for metatarsalgia surgery. Of the remaining 25% of people who receive surgery, 20% feel improvements, although they maintain some limitations in the use of footwear and their daily activities. The other 5% do not improve or worsen their initial condition. From this we can conclude that metatarsalgia surgery does have a high success rate.

Foot surgeries tend to have a very bad reputation when it comes to pain. But the truth is that, with highly specialized surgical and anesthetic techniques, the pain will not be too much. During the surgical procedure, the patient will not feel anything, since the foot will remain under the effect of local anesthesia for more than 4 hours. The pain will begin to be felt when the patient is at home, and the effect of the anesthesia has passed. It is normal to feel pain and discomfort for the first few days. However, the doctor will indicate what to do to minimize the pain, in addition to prescribing an analgesic plan. After the first week of recovery, the pain will decrease significantly, until it disappears as the days progress.

After metatarsalgia surgery, it is important to follow the guidelines for the early stages of recovery. Complying with them will allow the surgery to have been worth it at the end of the convalescence period. Some of the things that the patient can and cannot do after surgery are the following:

• Do not support the weight of the body on the affected foot, until the surgeon indicates.
• Avoid walking for the indicated time. Only walk for really necessary things.
• If the patient needs to walk, they should use crutches or trauma shoes.
• When you get home after surgery, the patient should keep the foot elevated for as long as possible for several days.
• Do not take public transport, to avoid injuring the operated foot.
• Come with a companion to metatarsalgia surgery.
• Stay at home when the operation is over.
• Have someone accompany you during the first days of recovery.
• Do not drive until the doctor tells you to.
• If you can’t find someone who can stay at home, the patient must stay at someone else’s house.
• Keep the foot with the bandage that is placed after surgery, until the surgeon removes it.
• Do not wet the foot or wash it until the surgeon tells you to.
• Call a doctor right away if the bandage comes loose or if there is bleeding.
• Put your foot up as long as possible from the first day and during the first weeks.
• Avoid climbing stairs. Only do it if absolutely necessary.
• Apply ice packs (without wetting the bandage) every day every 4 hours. Put them on top of the bandage.

From the third week, when the surgeon has already removed the stitches from the wound, patients will be able to take their first steps. In the fourth or sixth week, you can begin to wear normal shoes, if appropriate. It is common for the foot to swell in the afternoon and at night. To minimize this, you should alternate between resting and walking so that you don’t overstrain the area of the operation.