Question
QUESTION: I had bunion surgery in August of 2008.  It is now October of 2009 and I still have pain.  I went to get a second opinion and the dr gave me a cortizone shot(April 2009).  It helped some, but there is definite nerve pain too.  Now the pain before the cortizone shot is back, so I have nerve pain and joint pain. I have had an MRI and an xray, but no one sees anything.   Can you tell me what my next step should be.  What type of Dr should I see?  Is there anything that can be done and is stuff like this covered under insurance typically?  It is really affecting me physically and mentally.  There is only one pair of shoes I can wear that I can get through the day in, and my foot still hurts even in these.  I can't wear sneakers and I can't walk for exercise.  Thank you in advance for your help.

ANSWER: If you stand a lot or are overweight-that will add time to the healing process.
It can take up to 6 months for the nerves to heal and up to 3-4 months for the joint surgery to heal. You should really be able to have an open dialogue with one of the doctors and also accept the possibility that there may be some leftover discomfort.This needs to be explained to you in language you can understand. Ask the doctors directly, and try top pick among the 2-3 if you go to another doc. Don't seek perfection-seek answers that you understand.
If it is nerve pain due to irritation-then that should get better.If it is nerve pain due to a surgical problem-that might not get better without more surgery. I always have this conversation with my patients and let them know that surgery does have risks. That said...
Sometimes physical therapy and injections may help. Soft orthotics may help.
See a podiatrist who is board certified and does second surgical opinions and can do alcohol injections.
Sometimes these may be beneficial in deadening the nerve pain-but wait 6 months after the surgery before you do alcohol injection. Try the other options first.
Wish I could help you more!
We are located in Chicago and do second opinions

Good Luck!
Hope this helps!

Dr George Tsatsos
Chicago Podiatrist 60618,60661
Elmhurst Podiatrist 60126
Board Certified in Foot and Ankle Surgery & Orthopedics
New Chicago South Loop Location
AnkleNFoot.com

NOT MED ADVICE-ANY PAIN,SYMPTOMS OR CONCERNS CONTACT YOUR DOCTOR IMMEDIATELY
JUST INFO FOR ALL

---------- FOLLOW-UP ----------

QUESTION: Thank you for your answers.  It has already been 1 1/4 years since the surgery.  I have never heard of alcohol injections.  Who would know about that?  I'v already had one second opinion and he didn't tell me anything different than the first dr.  I do know there were risks, but the pain can be excruciating at time.  It is definitely worse now than it was before the surgery.

Answer
You need to find an opinion who will tell you the exact cause of pain following your bunion surgery!
For example-If the pain is due to a nerve that may have become trapped after surgery-then that may respond to an alcohol injection-which deadens the pain. Plus-if that's the case-the doctor needs to say that's what happened and be truthful(May not be the case).
If there are other issues-for example- a bone issue-then the injection may not work.
Not that you want to hear this, but sometimes these issues respond to a revision surgery
Since you have had this for a long time-then a little longer should be O.K. until you find someone who is able to give you the right diagnosis and treatment.
Seek a podiatrist who is Board Certified in Surgery and also does revision surgery. They usually are also aware of the alcohol injections.

Don't know where you live-but it may be worth your while to visit us in Chicago

Good Luck!
Hope this helps!

Dr George Tsatsos
Chicago Podiatrist 60618,60661
Elmhurst Podiatrist 60126
Board Certified in Foot and Ankle Surgery & Orthopedics
New Chicago South Loop Location
AnkleNFoot.com

NOT MED ADVICE-ANY PAIN,SYMPTOMS OR CONCERNS CONTACT YOUR DOCTOR IMMEDIATELY
JUST INFO FOR ALL