Insole for ankle valgus deformation?

looseparts

(First ever arthritis post) I've known for many years that I have osteoarthritis in my left ankle, but within the last year I've noticed my foot is not where it used to be. It has moved away from the bottom of my leg to the outside, and looks a lot different that the right. My Primary Care provider sent me to a podiatrist. The podiatrist wants to fit me for $400 orthotic insole for my shoe, despite finally agreeing that it will not actually help my situation or alleviate my pain. Everything I've read says I will need surgery, but the podiatrist insists we 'try everything first' even though he admits it won't help. Now I'm going through a whole bunch of hoops to get to see an orthopedic surgeon. Am I taking the wrong path? Thanks for your help.

stickywicket

Hello looseparts. It's nice to meet you though, as we say round here, I'm sorry you had to find us.

It sounds, from what you write, that you are not based in the UK. I have a son in the USA and am aware of the difficult decisions that have to be made over health matters. When one is paying for treatment it's vital to get it right and not waste money on things that might not be helpful.

My own OA is a result of many, many years of RA and both my feet stick out. I've never had surgery on them and eventually my ankles have fused themselves. This, stops the ankles hurting but not the rest of the feet. I wear surgical shoes, with orthotic insoles because without them I can hardly walk at all. They do make a difference and also help to ensure that other joints, above them, are not put under pressure by being used awkwardly due to the feet.

I would hope that your orthopaedic surgeon would give good, impartial advice but I know that doesn't always happen when money is changing hands. I think you can only listen to what he says then take your time to think things over. I hope things turn out well for you.

looseparts

stickywicket, Thank you for your information about your own experience - it has been very helpful. I will probably consult this forum as well as the doctors that are available to me before doing anything drastic.

You bring up a very good point about the rest of my foot. I've mentioned the pain I have in adjoining areas (sometimes top of foot, sometimes inside the arch, etc.) to family and doctors, only to get blank stares. It's nice to hear that I'm not the only one with such and/or that the issues are related.

Therefore it makes sense that fusing the ankle will not solve all my problems and after a lengthy and expensive recovery, things might be worse in other places or who knows?!!

This decision about having surgery isn't something I need to decide today, so while the prognosis doesn't make me happy, it's nice to find you all for the kind support you give one another. I'll stay in touch. Thanks, Jon

MrOptimist

Hello Jon,

I am sure that SticyWicket's reply has helped enormously. However, when making an assessment of your condition, one would hope that your doctor also considered the following :

Weight Loss (which may or may not be appropriate)

Activity Modification

Inflammatory Medication

Physical Therapy (an evaluation of the mechanics of the way you foot is working and appropriate advice)

Orthotic Management (as already suggested)

Surgery would 'always' be considered the last option - and rightly so.

I hope this information has helped and wish you the best for the future

dreamdaisy

Hello looseparts - I love the name! I am no expert on arthritis (depsite having lived the past seventeen years with it) but it would seem to me that if your foot is turning outwards then the ankle damage is too extreme to be helped by an insole or anything else - it's hardly likely to regain its original, natural position. I have OA in both ankles and both knees, plus toe damage caused by my psoriatic arthritis - I can empathise with your discomfort.

I have orthotic insoles and they make life more miserable because they are doing their job, ie better supporting my flat arthritis-affected feet and they also straighten my kneecaps. Ouch. It seems odd that they are telling you that what they propose won't help but, as Sticky said, when money is changing hands maybe patient benefit is not the first concern. I think save your $400 and I hope you can see an ortho chappie soon because your right foot will be taking a deal of strain and that could upset it. Are you using a cane? If not I recommend one because that will help ease the stress on the poorly joint - the cane should be held on the right side, OK? Please keep in touch with us and let us know how things progress. I wish you well. DD