Bunion surgery said to be pain free





By Michael Zapf, DPM

I recently accomplished a tripleheader of sorts: "the triple no pain" play. On that day I performed three relatively routine bunionectomies. What made them special was that the three patients reported that they did not need to take even one pain pill. I am reporting this not to brag, but to dispel one of the myths of foot surgery—that it is always painful.


I did my foot surgery residency in the mid-1980s. Patients at that time routinely spent three days in the hospital for a bunion surgery. Insurance companies were the first to see the needless coddling these patients were receiving and stopped paying for overnight stays for bunion surgeries. And to tell the truth, they were right. By 1987 nearly all bunion surgeries were performed on an outpatient basis and they rarely needed more than a prescription of pain pills, and sometimes less.


Since that time foot surgeons have refined their techniques to what they are today: highly predictable and usually nearly painless. Most bunion surgeries are done at a surgery center or the outpatient department of a hospital. Patients return home only a few hours after the procedure and usually walk the same day in a post-operative surgical shoe.


Among the techniques that make this procedure, and most foot surgery for that matter, less painful is the delicate handling of the foot during surgery. When an instrument is used that might create heat, a cool irrigation is used. When a bone is cut, it is done in such a way as to minimize any movement of the pieces. If that can’t be done, screws are used to eliminate movement that would otherwise result in pain.


During the procedure a long-acting Novocain-like anesthetic is used so that there is no pain on waking up. I like to have my patients take an anti-inflammatory medication starting two days before surgery. This is called preemptive analgesia. After surgery the use of ice packs reduces painful inflammation even more.


Maybe there are reasons not to have a bunion repaired—perhaps other medical conditions or the timing is inconvenient—but the fear of pain should not be one of them.


Dr. Michael Zapf is a podiatrist in private practice in Agoura Hills and Thousand Oaks.


For more information on bunions and foot care, see the Web site: www.conejofeet.com or call the office at (818) 707-3668.



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