2nd to numbness problem with foot orthosis

2nd to numbness problem with foot orthosis

Algonquin Orthopaedics

11/24/2000

Hi All,

I have a 55 yr old female, slightly overweight I've fit with bilateral
semi-rigid full length foot orthoses (firm and extra firm nickleplast,
PPT). She has had a R bunionectomy in 1994 with no follow-up or foot
orthoses post surgically. She presents with bilateral calcaneal valgus ~ 3
degrees, collapsed med long arch and transverse arches, bilateral ~ 5
degree fore foot varus, a R dorsiflexed 1st ray and bilaterally the second
toe is longer than the first. She also has a 10 mm leg length disc ( R<L)
and a painful hip. I have successfully corrected all the above mechanics
as well as leg length problems and eliminated the hip pain. My only symptom
now left (and unfortunately one I've caused) is a numb R 2nd toe as the
distal tip. I've tried unloading that section of the orthosis - no change.
I've increased the calcaneal valgus correction (theorizing that the medial
plantar nerve was being stretched/compressed and further correction would
unload) -- no change. I've increased the transverse arch correction
thinking that the common digital nerve is being compressed -- no change.
I've asked about previous lower back pain thinking that possibly the L4, L5
nerve may be the culprit -- no previous LBP.

I'm wondering if anyone has any suggestions or thoughts as I'm getting to
the end of my scientific approach and feeling like I'm going to have to
guess the next time she comes in.

Any ideas or past history experiences would really be welcome.

TIA.


Cameron Renwick, C.O.(c)
Algonquin Orthopaedics
228 Main ST. West
Huntsville, Ont., P1H 1Y1
www.orthotics.on.ca