Enjoy your day! Two more days and I'm at 3 weeks!!! Whoo Woo!!! Sorry folks, but updates on the foot are becoming less and less since not much is changing. I feel like I'm at a good spot regarding being able to walk, not experiencing pain, trying to do the toe exercises. I'd like to say my black and blue color is going down slightly. The little white strips are making their way off the scar. One fell off and three look like they will be coming off soon and two look like they are on normal. All is going good - knock on wood!! Metatarsalgia is often described as a burning sensation in the ball of the foot, combined with excess callous forming. Ball of Foot Pain (Metatarsalgia) occurs when the metatarsals (forefoot bones) drop and the surrounding ligaments weaken. The entire forefoot structure collapses, which then leads to excess pressure and friction under the ball of the foot. Foot pain can be caused by a variety of health complications, including complications associated with bunions. If you are concerned that you have a complication with a bunion, be sure to meet with a podiatrist as a hallux valgus bunion may be the diagnosis and require more advanced treatment. Over 150 different operations have been described for the treatment of hallux valgus. A selection of better-known procedures is presented in Table 1 and Figure 2 In our experience, metatarsalgia can be effectively alleviated with insoles. These must have a pad that exerts upward pressure on the metatarsals proximal to the pressure-sensitive metatarsal heads. The literature contains only few prospective randomized trials comparing different surgical procedures or investigating conservative treatment. Four studies that did compare procedures all came to no clear conclusion. Whether, for example, the adductor tendon should be divided or the intermetatarsal angle corrected has to be decided according to the individual deformity. Hallux valgus occurs commonly in osteoarthritis which is due to wear and tear of the joints. As a result of disease in the joint, the big toe can more easily become hallux valgus What are the common symptoms and complications of bunions? Painkillers such as paracetamol or the non-steroidal anti-inflammatory drug, ibuprofen, will often help relieve the pain and inflammation. However, they will not reverse the progression of the condition and should only be considered as temporary relief while adequate footwear is tried. Surgery Stand during the fitting process and check that there is adequate space (3/8" to 1/2") for your longest toe at the end of each shoe. Most bunions can be treated without surgery. But when nonsurgical treatments are not enough, surgery can relieve your pain, correct any related foot deformity, and help you resume your normal activities. An orthopaedic surgeon can help you decide if surgery is the best option for you. Whether you've just begun exploring treatment for bunions or have already decided with your orthopaedic surgeon to have surgery, this booklet will help you understand more about this valuable procedure. Failure to obtain pain relief from nonsteroidal anti-inflammatory drugs. Their effectiveness in controlling toe pain varies greatly from person to person. Realignment of the big toe is then done by releasing the tight structures on the lateral, or outer, side of the first MTP joint. This includes the tight joint capsule and the tendon of the adductor hallucis muscle This muscle tends to pull the big toe inward. By releasing the tendon, the toe is no longer pulled out of alignment. The toe is realigned and the joint capsule on the side of the big toe closest to the other toe is tightened to keep the toe straight, or balanced Michael L. Richardson, M.D. Sigvard T. Hansen, M.D. Ray F. Kilcoyne, M.D. Departments of Radiology and Orthopaedic Surgery University of Washington In Scarf method, the 1st metatarsal bone is cut longitudinally into two parts so that the cutting line resembles the letter Z. Then a further fragment is moved laterally against the proximal fragment, which remains in place. If required by the primary distortion, it is possible to shorten the fragments. The cut fragments are held close together on the screw and are then stabilized with two special screws. Ill-fitting shoes, particularly those with tight toe boxes, create friction and pressure on toes, aggravating bunions and causing pain while running. Running also increases repetitive pressure on the big toe's joint and the ball of the foot, another source of bunion pain. The most common cause of this deformity is tight, poorly fitting shoes. Sometimes there are structural deformities of the foot that place abnormal pressure on the bones in the feet creating the hallux valgus deformity. Pressure over the metatarsal bone in the foot causes the bone to point abnormally and force the toe to point outwards and the metatarasal bone to point in. If a change in footwear does not help, you may referred to an orthopaedic surgeon. The most common operation performed for bunions is called an excision arthroplasty. The surgeon will cut way the part of the big toe joint that is sticking out and causing the trouble. Poor fitting and high style shoes are usually blamed as the culprit for the formation of this deformity (that is why they are more prevalent in women), but the truth is most of these deformities are an inherited feature. More specifically, this pathology is related to foot structure and function both of which are inherited features. Once the decision is made to have a bunion surgically corrected it now falls upon the surgeon to determine the type of procedure to be performed. Not all bunion deformities are the same; that is essentially why one's surgical experience will probably differ from the next person. Having bunions can also make it more difficult to find shoes that fit properly; bunions may force a person to have to buy a larger size shoe to accommodate the width the bunion creates. When bunion deformity becomes severe enough, the foot can hurt in different places even without the constriction of shoes because it then becomes a mechanical function problem of the forefoot. Pathophysiology edit At present there are many different bunion surgeries for different effects. The age, health, lifestyle and activity level of the patient may also play a role in the choice of procedure.