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I once had a bad sesamoid bone in my left foot, which was removed many years ago. However it was later discovered that the wrong sesamoid bone was removed. The bad sesamoid bone had to then be removed since pain was worse than before. After allowing proper healing time, the pain persisted.
With two additional exploratory surgeries, it was found the FHL tendon was badly damaged due to 4 bone fragments being left behind. Bone fragments were then removed. Joint was unstable and a new sharp pain emerged to which that doctor opted to fuse the first interphalangeal joint via Titanium staples.
I used to be a runner, hiker, biker, and skier before this, and now I can barely walk because of the pain and swelling. I have tried numerous orthotics and modified shoes, however the pain is worse than ever before. I feel at the end of my ropes and am trying to see if there are any other options out there.
The pain is under the foot throughout the first and second interphalangeal joint. If I walk for just a bit, such as when I travel for work, my whole great toe swells and is extremely painful. Are there any last types of interventions that can be recommended to me besides more orthotics alterations? I am okay with non-invasive or invasive methods, and am okay with the sacrifice of hallux functioning. Pain relief is my main priority so that I can walk around in my home comfortably.
Have you tried a stiff soled shoe or a show with a rocker (like the Hoka running shoes)?
I suspect the next step would be more advanced imaging to try and workout exactly what is causing the symptoms. This is pretty hard to sort out online as due to the surgeries, your poblem is quite complex.