Surgery for Flat Feet - Good Idea?.... Not

I was reading an article in the NY Times about actor Gbenga Akinnagbe who decided to have surgery to correct flat feet (read the entire article at http://www.nytimes.com/2010/05/04/health/04case.html?ref=health).  Out of desperation, he decided to undergo a surgical procedure to correct a severe problem in his feet to relieve knee and back pain.  Apparently he had tried foot orthotics and other therapies with no real improvement and decided to do this instead. He had his left foot done first and is waiting to do his right one next.

After being in health care for 23 years, I have seen many people resort to many crazy things such as this with varying results.  Almost daily, I am visited by frustrated athletes and regular folks who are in chronic pain in their joints and their doctors just don't understand. Orthotics are casted poorly and are ineffective, they are aggravated rather than helped by therapies and few people they visit understand why they are hurting, even though they pedal cures that "may helP.W"  Recently, I was visited by a woman who hurt her back initially a few months ago, was then told to have an MRI to rule out a disc problem, was then told she had uterine fibroids and needed a hysterectomy and then when she began having knee pain, the orthopedic told her to have knee surgery first.   This patient is a classic case who is drawn into the system and told to do painful and disfiguring things to herself in the name of health.  I sat with her for 20 minutes and explained her symptoms made sense, to get a second opinion on the hysterectomy and to avoid the orthopedic doctor for her knee.  I just completed her third visit today and she will be planting flowers tomorrow for mothers day instead if being miserable and in pain.  She is literally reclaiming her life from the medical experts after a couple of visits and now understands why she was in pain. She cancelled her hysterectomy as well, opting for something more sensible . Informed consumers of health care are not our systems best customers since they will opt out of a bad situation once they finally understand it.


I bring this up because mismanagement of the musculoskeletal system is rampant in our health care system and people who lose hope or are scared are its best customers.  Is it any wonder health care costs are out of control?  


Regarding the actor in the article, I have never had to resort to recommending a surgery for anyone who has e severe foot overpronation which by the way is an inherited trait.  Some of our severe overpronators run marathons.  I believe this gentleman has likely never visited the right doctor who understands his problem and can intelligently treat it conservatively.  Foot overpronation and the pain it can produce is nicely controlled with foot orthotics, myofascial release and repatterning or movement and the myofascial surrouding the core and the lower kinetic chain.  Chiropractic adjustments to the spine and the extremities will help improve movement and reduce pain further while improving outcomes non surgically.  In the case of clubbed feet, surgery is necessary and this is typically corrected in early childhood.  In the case of this gentleman, it is too bad we never met.  The solution is easier than he was lead to believe and much less painful and disabling too.


What do you think?  I value your opinion.