To Operate or Not: Navigating Surgery Decisions for Foot Pain

To operate or not to operate?

I have been experiencing sharp pain in the tips of my left foot's ring and middle toes for 4-5 years.
The frequency and duration of the pain have been increasing, often waking me up multiple times at night, especially before my menstrual period.
This year, if I sleep on my left side, my left foot becomes numb.
Due to enduring the pain for so long, I have also developed issues with my temporomandibular joint and am currently undergoing treatment with a bite splint.
Recently, after an MRI, it was discovered that there is a mass located about 7 centimeters above the back of my left knee.
The doctor diagnosed it as a nerve sheath tumor, but he mentioned that surgery could lead to complications.
If the tumor is on a sensory nerve, I may experience numbness or loss of sensation in my left foot; if it's on a motor nerve, I may lose the ability to lift my left toes and it could affect my normal walking.
The doctor said that these potential complications are possible if I choose to have surgery and advised me to make my own decision regarding the surgery.
I am very concerned about the possibility of not being able to walk normally after surgery, as I need to work to earn a living.
I would like to ask the doctor if I should take the risk of surgery or if there are other treatment options available for me.

Miss Zhang, 50~59 year old female. Ask Date: 2015/12/21

Dr. Chen Yongxue reply Orthopedics

Hello, your situation is described in great detail in your letter, and I sincerely empathize with you.
However, every surgery carries its risks, and even physicians themselves are not exempt from this.
Ultimately, the decision of whether to undergo surgery is one that only you can make; no one else can decide for you.
In short, if the symptoms in your toe have become unbearable and you are willing to take the risk of surgery, then it may be the right time to proceed.
Otherwise, consulting more experts may not change the current situation.
I apologize for not being able to assist you further.

Reply Date: 2015/12/21

More Info

When faced with the decision of whether to undergo surgery for foot pain, particularly in the context of a diagnosed neuroma or a similar growth like a nerve sheath tumor, it is essential to weigh the potential benefits against the risks involved. Your situation, characterized by chronic pain in your left foot and the recent diagnosis of a nerve sheath tumor, presents a complex dilemma.

Firstly, it’s important to understand the nature of the tumor diagnosed as a nerve sheath tumor. These tumors can vary in their behavior, with some being benign and others potentially causing significant discomfort or functional impairment. The symptoms you describe, including pain that disrupts your sleep and the sensation of numbness or tingling, suggest that the tumor may be affecting nearby nerves, which could explain the increasing severity of your symptoms over the years.

Your physician has rightly pointed out the potential risks associated with surgical intervention. If the tumor is located near sensory nerves, there is a risk of postoperative complications such as numbness, tingling, or weakness in the affected area. These risks can be particularly concerning if your work requires mobility or physical activity. On the other hand, if left untreated, the tumor may continue to grow, potentially exacerbating your symptoms or leading to further complications.

Before making a decision, consider the following steps:
1. Seek a Second Opinion: Consulting another orthopedic surgeon or a specialist in foot and ankle surgery can provide additional insights into your condition and treatment options. Different surgeons may have varying levels of experience with similar cases and can offer alternative perspectives on the necessity and timing of surgery.

2. Explore Non-Surgical Options: Depending on the nature of the tumor and your symptoms, there may be non-surgical treatments available. These could include physical therapy, pain management strategies (such as medications or injections), or alternative therapies like acupuncture. While these may not eliminate the tumor, they could help manage your symptoms and improve your quality of life.

3. Consider Your Quality of Life: Reflect on how the pain and symptoms are affecting your daily life and work. If the pain is significantly impacting your ability to perform your job or enjoy daily activities, this may weigh in favor of surgical intervention despite the risks.

4. Discuss Recovery and Rehabilitation: If you decide to proceed with surgery, inquire about the expected recovery process. Understanding what rehabilitation will entail, including physical therapy and any necessary lifestyle modifications, can help you prepare for the post-operative period.

5. Evaluate Risks vs. Benefits: Ultimately, the decision to undergo surgery should be based on a thorough understanding of the potential risks and benefits. Discuss these in detail with your surgeon, considering factors such as the likelihood of symptom relief, the potential for complications, and how surgery might impact your long-term mobility and quality of life.

In conclusion, the decision to operate or not is highly personal and should be made after careful consideration of all factors involved. Engaging in open discussions with your healthcare providers, exploring all treatment options, and considering your personal circumstances will help you make an informed choice that aligns with your health goals and lifestyle needs.

Similar Q&A

Post-Surgery Pain: Seeking Help for Persistent Leg and Foot Discomfort

Hello, I underwent spinal fusion surgery on March 14 this year. Since the surgery, I have been experiencing pain on the left side from my hip to my knee, and then from my calf to my ankle with sharp pain, along with numbness in the soles of my feet. I cannot sit or stand without ...

Dr. Chen Bingze reply Surgery
This issue is indeed quite troublesome. If you really want to seek treatment, you might consider consulting Dr. Hou Chung-Pao at the Force Rehabilitation Department. Please have him evaluate your condition, and we can discuss further steps in a follow-up communication.

Non-Surgical Options for Fifth Metatarsal Fractures: What You Need to Know

Hello, doctor. I have attached my X-ray images. This is the current situation. The doctor here mentioned that surgery is basically optional, but the bone will grow in a misaligned direction, which may lead to subsequent pain. I would like to ask if it is possible to avoid surgery...

Dr. Shi Guozheng reply Orthopedics
1. Surgery is possible. 2. There is no impact. 3. There are no issues with blood supply. 4. Bone spurs will not develop. 5. Surgery may not heal properly. 6. Surgery is not recommended.

Managing Painful Bunions: Seeking Effective Treatment Options

I apologize! I have a problem with bunions that I would like to ask about. I visited your hospital for a consultation last time, but the doctor only took a quick look and said it wasn't serious. He measured my foot and said that if the bunion was under 9 centimeters, surgery...

Dr. Shi Qiming reply Orthopedics
Regarding the correction surgery for hallux valgus, it is generally considered for patients with a larger angle and severe pain when conservative treatments have not provided improvement. In your case, you may want to visit an orthopedic outpatient clinic or consult with a foot a...

Understanding Toe Pain: When to See a Surgeon for Relief

I have pain in my second toe, and it also hurts when I touch it. Should I see a surgeon? What could be the cause? Will I need an X-ray of my foot? Thank you.

Dr. Huang Junxiong reply Surgery
Hello: Based on your description, it is difficult to determine the specific condition. It is advisable for you to consult a surgical outpatient clinic.