Medically reviewed by Dr. Tom Biernacki, DPM · Board-Certified Podiatric Surgeon · Last reviewed: April 2026 · Editorial Policy
Quick Answer
Midfoot Arthritis: Tarsometatarsal Joint Fusion — Indi relates to foot pain — typically caused by overuse, footwear, or biomechanics. Most patients improve in 6-12 weeks with conservative care. Same-week appointments in Howell + Bloomfield Twp: (810) 206-1402.
Quick Answer
Most foot and ankle problems respond to conservative care — proper footwear, supportive inserts, activity modification, and targeted stretching — within 4-8 weeks. Persistent pain beyond that window, or any symptom that prevents walking, warrants a podiatric evaluation to rule out fracture, tendon tear, or systemic cause.
Treatment at Balance Foot & Ankle: Morton's Neuroma Treatment →
Medically Reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatrist, Balance Foot & Ankle Specialists, Michigan. Last updated April 2026.
Midfoot arthritis — degenerative joint disease of the tarsometatarsal (Lisfranc) joint complex producing chronic dorsal midfoot pain, stiffness, and inability to tolerate prolonged walking or standing — most commonly develops as a post-traumatic sequela of Lisfranc ligament injury (often previously undiagnosed), as the end stage of adult-acquired flatfoot with midfoot collapse, or as idiopathic primary degenerative arthritis. When conservative management fails (custom orthotics, NSAIDs, corticosteroid injections, rocker-sole shoes), tarsometatarsal arthrodesis provides reliable, durable pain relief with preservation of overall foot function — since the Lisfranc joint complex accounts for less than 10% of total foot motion in gait.
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Diagnosis and Conservative Management
Clinical features: deep, aching midfoot pain with prolonged walking and standing; direct tenderness on palpation over the tarsometatarsal joints (first–third TMT joints most commonly affected); pain with passive torsion of the midfoot; swelling and bony prominence over the dorsal midfoot from osteophytes. Weight-bearing imaging: bilateral weight-bearing AP, lateral, and oblique foot X-rays — shows joint space narrowing, subchondral sclerosis, dorsal osteophyte formation, and midfoot sagittal collapse (naviculocuneiform sag and first TMT dorsal angulation on lateral view). CT scan: superior assessment of individual joint involvement; identifies which specific TMT joints require fusion. Fluoroscopic joint injection with lidocaine: diagnostic injection of individual symptomatic joints confirms the pain source and predicts surgical response — relief with injection predicts good surgical outcome. Conservative treatment: rocker-sole shoe (Carbon fiber foot plate); custom arch-supportive orthotic with first ray extension; NSAIDs and activity modification; corticosteroid injection into affected joints; 6–12 months of conservative care is appropriate before surgical planning.
Surgical Arthrodesis
Medial column fusion (first, second, third TMT joints): the most commonly required procedure — dorsal approach with medial and intermediate incisions; periosteal stripping and joint preparation with curettes and osteotomes; autologous bone graft (iliac crest or local calcaneal bone) for any defects; rigid fixation with low-profile locking plates and screws; deformity correction (midfoot elevation of collapsed segment) during fixation. Selective vs. pan-midfoot fusion: only definitively arthritic joints require fusion — joint injection responses and CT findings guide selection; fusing asymptomatic joints increases recovery burden without benefit. Weight-bearing and recovery: non-weight-bearing cast 6–8 weeks; progressive weight-bearing in a boot at 8–10 weeks; union confirmed by CT at 3–4 months; return to supportive shoes at 4–5 months. Outcomes: 80–90% patient satisfaction; durable pain relief at 5–10 year follow-up; adjacent joint arthritis (naviculocuneiform, calcaneocuboid) is the primary long-term complication. Dr. Biernacki at Balance Foot & Ankle evaluates and performs midfoot arthrodesis for tarsometatarsal arthritis at our Bloomfield Hills and Howell offices. Call (810) 206-1402.
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Our board-certified podiatrists treat this condition at two convenient locations. Same-day appointments often available.
More Podiatrist-Recommended Arthritis Essentials
Cushioned Running Shoe
Hoka Clifton 10 — max cushioning reduces joint impact for arthritic feet.
Wide Walking Shoe
- FuelCell foam delivers a propulsive feel to help drive you forward
- ENCAP midsole cushioning combines lightweight foam with a durable polyurethane rim to deliver all-day support
- Reflective accents designed to catch the light
- TPU back tab
- New Balance MADE contains a domestic value of 70% or more. MADE makes up a limited portion of New Balance’s US sales.
New Balance 990v6 — wide toe box accommodates arthritic first-MTP (hallux rigidus).
Orthotic Insole
- The Pinnacle Full length insoles for men & women provide maximum cushioning, from high activity to moderate support. The PowerStep arch support shape provides stability to the foot and ankle, helping to relieve foot pain.
- When you spend all day on your feet, every step counts. PowerStep insoles are a podiatrist-recommended orthotic to help relieve & prevent foot pain related to athletes, runners, Plantar Fasciitis, heel spurs & other common foot, ankle & knee injuries
- The Pinnacle plantar fasciitis insoles offer superior heel cushioning and arch support. The dual-layer cushioning is designed to reduce stress and fatigue, while PowerStep premium arch support is designed for plantar fasciitis relief.
- The PowerStep Pinnacle arch support inserts for men & women can be worn in a variety of shoe types such as; athletic, walking, running, work & some casual shoes. Orthotic Inserts are ordered by shoe size, no trimming required.
- Made in the USA & backed by a 30-day money-back guarantee. PowerStep orthotic inserts for men & women are designed for shoes where the factory insole can be removed. HSA & FSA Eligible
PowerStep Pinnacle — offloads the big toe joint during gait.
As an Amazon Associate, Balance Foot & Ankle earns from qualifying purchases. Product recommendations are based on clinical experience; prices and availability shown above update live from Amazon.
When to See a Podiatrist
Foot and ankle arthritis progresses silently — cartilage doesn’t regrow, but joint fusion, cheilectomy, and biologic injections can restore function at every stage. Balance Foot & Ankle offers the full arthritis spectrum: bracing, injections, and reconstructive surgery. Start with a consult so we can image the joint and give you a realistic 5-year outlook.
Call Balance Foot & Ankle: (810) 206-1402 · Book online · Offices in Howell & Bloomfield Hills
Frequently Asked Questions
When should I see a podiatrist?
See a podiatrist for any foot or ankle pain that persists more than 2 weeks, doesn’t improve with rest, limits your daily activities, or is accompanied by swelling, numbness, or skin changes. People with diabetes or circulation problems should see a podiatrist regularly even without symptoms.
What does a podiatrist treat?
Podiatrists diagnose and treat all conditions of the foot, ankle, and lower leg including plantar fasciitis, bunions, hammertoes, toenail problems, heel pain, nerve pain, diabetic foot care, sports injuries, fractures, and foot deformities — both surgically and non-surgically.
What can I expect at my first podiatry visit?
Your first visit includes a full medical history, physical examination of your feet and gait, and in-office diagnostic imaging if needed (X-rays, ultrasound). We’ll discuss your diagnosis and create a personalized treatment plan. Most visits take 30–45 minutes.
Need Treatment at Balance Foot & Ankle?
Dr. Tom Biernacki, Dr. Carl Jay, and Dr. Daria Gutkin see patients at our Howell and Bloomfield Township offices.
Book Online or call (810) 206-1402
Insurance Accepted
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Howell Office
3980 E Grand River Ave, Suite 140
Howell, MI 48843
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Bloomfield Hills Office
43700 Woodward Ave, Suite 207
Bloomfield Hills, MI 48302
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Your Board-Certified Podiatrists
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Same-week appointments available at both locations.
Book Your AppointmentMost Common Mistake We See
The most common mistake we see is: Waiting too long before seeking care. Fix: any foot pain lasting more than 4 weeks, or any sudden severe symptom, deserves a professional evaluation rather than more rest.
Warning Signs That Need Same-Day Care
Seek immediate evaluation at Balance Foot & Ankle if you experience any of the following:
- Unable to bear weight
- Severe swelling with skin colour change
- Fever with foot pain (possible infection)
- Diabetes plus any new foot symptom
Call (810) 206-1402 — same-day and next-day appointments at our Howell and Bloomfield Hills offices.
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Podiatrist-recommended products
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Related resources
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Same-week appointments · Howell & Bloomfield Hills · 4.9★ (1,123+ reviews)
☎ (810) 206-1402Book Online →Pros & Cons of Conservative Care for foot care
Advantages
- ✓ Conservative care first
- ✓ Same-week appointments
- ✓ Multiple insurance accepted
Considerations
- ✗ Self-treatment can mask issues
- ✗ See a podiatrist if pain >2 weeks
Dr. Tom’s Recommended Products for foot care
Affiliate disclosure: As an Amazon Associate, Balance Foot & Ankle earns from qualifying purchases. We only recommend products we use with patients.
Footnanny Heel Cream Dr. Tom’s Pick
Best for: Daily moisturizer for cracked heels
Ready to Get Back on Your Feet?
Same-day appointments in Howell + Bloomfield Twp. Most insurance accepted. Dr. Tom Biernacki, DPM & team.
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About Your Care Team at Balance Foot & Ankle
Dr. Tom Biernacki, DPM · Board-Certified Foot & Ankle Surgeon. Specializes in conservative-first care, minimally invasive bunion surgery, and complex reconstruction.
Dr. Carl Jay, DPM · Accepting new patients. Specializes in sports medicine, athletic injuries, and routine podiatric care.
Dr. Daria Gutkin, DPM, AACFAS · Accepting new patients. Specializes in surgical reconstruction and pediatric podiatry.
Locations: 4330 E Grand River Ave, Howell, MI 48843 · 43494 Woodward Ave Suite 208, Bloomfield Twp, MI 48302
Hours: Mon–Fri 8:00 AM – 5:00 PM · (810) 206-1402
Dr. Tom Biernacki, DPM is a double board-certified podiatrist and foot & ankle surgeon at Balance Foot & Ankle Specialists in Southeast Michigan. With over a decade of clinical experience, he specializes in heel pain, bunions, diabetic foot care, sports injuries, and minimally invasive surgery. Dr. Biernacki is a member of the APMA and ACFAS, and his patient education content on MichiganFootDoctors.com and YouTube has reached over one million views.
Frequently Asked Questions
Can a podiatrist treat arthritis in the foot?
How much does a podiatrist visit cost without insurance?
- Plantar Fasciitis: Diagnosis and Conservative Management (PubMed)
- Plantar Fasciitis (APMA)
- Diagnosis and Treatment of Plantar Fasciitis (PubMed / AAFP)
- Heel Pain (APMA)
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Our board-certified podiatrists offer advanced treatments at our Bloomfield Hills and Howell locations.
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