As a surgeon I occasionally get asked by patients visiting our centre “is foot surgery as painful as they say”? During this blog I will discuss why, with modern surgical and anaesthetic techniques and up to date rehabilitation programs, most patients tend to have a positive experience with foot surgery.
Foot surgery in the past
There is commonly the misconception that foot surgery, in particularly bunions, is the most painful surgery you can ever experience! I’ve been told by a few patients that their perception is that spine and foot surgeries are the worst in terms of pain. Although I can’t comment on spinal surgery, our understanding of foot surgery has certainly changed a lot over the last twenty years. A lot of people are basing the statement on what a relative or friend had told them of their experience from many years ago. This often involved painful surgery, extended periods in hospital, having their foot put in a bulky plaster and not being able to put weight through it for weeks or even months.
Advances in foot surgery
Using smaller incisions for bunion surgery, comprehensive pain relief during and following surgery and earlier weightbearing exercises the whole experience is greatly improved from yesteryear. A lot of foot surgery (including bunions) can be performed as a day case. This includes people who have both sides operated on meaning that you can recover in the comfort of your own home. All of this does not mean that patients are discharged in pain. We commonly use nerve blocks to ensure that your foot can be entirely numb (with no associated pain) for up to 24 hours post procedure. These blocks are performed whilst you are asleep by either the surgeon or the anaesthetist using ultrasound in theatre. The ultrasound is also used for some procedures such as ganglions to guide and minimise our incision. After surgery you are sent home with stronger pain relief and normally you take this as required for the first few days. Most patients are generally off this stronger pain relief by day 3-4 post surgery and then onto simple pain relief such as Panadol or anti-inflammatories. All procedures (including those performed in the bigger joints such as the ankle) you can walk on the operated leg straight away. For some of the procedures such as tendon reconstructions we advise partial weightbearing or 50% weightbearing. However, for many procedures, including bunions, you can put as much weight as you can tolerate through the foot from Day 1. We try to get you out of boots and braces as soon as possible. For bunion surgery you are in a postoperative shoe for 4 weeks only (followed by sports shoes for a further 6 weeks).
Foot Surgery in the future
We are constantly modifying techniques to continue to improve our patient experience. From advancing our surgical techniques, improving our pain relief and getting patients performing weight bearing exercises, our goal is to work with you to get you back on your feet and doing the things you love sooner.