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Unlike hallux rigidus a bunion is a lump at the base of the great toe, caused by sideways drifting and angulation of the great toe. The pain from a bunion is most commonly caused by pressure from shoes or, on occasions, by crowding or crossing over of the lesser toes. As with the arthritis of any joint, avoiding those activities which cause the symptoms is one option. Stiffening the sole of the shoe may also improve symptoms, although the effects are often short-lived.
Surgery should only be undertaken if your symptoms are significant, and appropriate treatment without surgery is not satisfactory to you.
This is an operation to remove the extra bump of bone (shaded in grey in the diagram) on the top of the big toe. After cheilectomy patients can suffer with persisting stiffness, or the arthritis can progress. A fusion is an operation when the bone at the base of the toe (the metatarsal bone) is fused to the toe bone (phalanx) producing a stiff joint.
Because the operation involves holding raw bone edges together while they heal, two internal screws are usually inserted. Both types of surgery are usually performed either as a day-case (where you do not have to stay in hospital over night at all), or with a stay in hospital over-night. To start with you will need to rest with your foot up, on a stool, or across the sofa, most of the time. In the longer-term many patients will be able to run and participate in sports after a fusion.
If you are slower than these times do not panic, they are only averages, but let your surgeon know when you attend the clinic. Most problems can be treated by medications, therapy and on occasions by further surgery, but even allowing for these, sometimes a poor result ensues.


Similarly if you get swelling of the leg or foot which does not settle when the foot is elevated above heart level you should seek medical advice. These guidelines are intended to help you understand your operation, and to help you to prepare yourself and your foot for it. When my shoes pressed against the back of my heel, it felt like someone was pressing down on a bruise.
Because the Achilles tendon attaches at the base of the heel, he said that most of the pain is probably coming from a tight Achilles due to running.
It was really humid out and I was sweating like crazy, so I spent the first 2 miles telling myself I would turn around early and only do 4 miles.
The lump of a bunion is found on the inside of the big toe, as opposed to the top in hallux rigidus. Your doctor will advise you if lesser forms of surgery such as removal of bony spurs is appropriate.
It increases joint movement, and is successful in reducing symptoms in 90% of patients with less severe arthritis. The foot is always painful, but it is usually possible to control the pain with oral medication.
If you have any general or specific worries, you should ask the doctor treating you who will explain it to you. It is important that you notify a doctor if you get an increase in pain after you go home, and particularly if the pain does not settle with elevation and mild painkillers, as this may indicate early infection. Please let your doctor or nurse know if this is the case, so we can address the matters of concern. I switched to wearing backless shoes as often as possible and made an appointment with a podiatrist. I am under orders to stretch my Achilles everyday, and wear shoes with a slight heel (no higher than 2 inches) to alleviate pressure on the tendon.


ReplyDeletejessexpressedSeptember 2, 2013 at 8:51 PMAt least you know what the issue is now and you can work with it in the future! The stiffness of the toe is especially noticeable on the upward bending caused by walking or running. In order to minimise swelling, you will need to keep your foot up after for the two weeks following the operation. It will be a further six to eight weeks before you can wear a standard shoe for a working day. Above all else please do not proceed with surgery unless you are satisfied you understand all that you want to about the operation. Then I turned around and felt the amazing breeze that had been undetectable behind me the whole time. I felt slow and sluggish, and I really wanted to turn around, but I hit my stride in the third mile.
Performing these exercises early, and regularly will help you to get the best possible result from your surgery. It is usually three to six months from the operation before you can hope to resume recreational walking or light sporting activities. We also advise against prophylactic surgery (surgery to avoid problems that are not yet present). I took a Gu (chocolate raspberry might be my new favorite), and it amazed me that I'm doing runs long enough to require Gu in the middle of the week. Both of my Achilles started to hurt around mile 9, and the last 2 miles in particular were tough.



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