Lapidus Procedure UK - Pain Relief? Any Advice?

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All advice is really helpful in prep for my op on 16th July.  I need to get this pain relief sorted.

My surgeon has recommended Ibroprufen 400 mg and Co -Codamol.

I notice some of you in the USA for example have taken Percocet and Tylenol.  Percocet is not used here in UK after 'Googling it'.

My problem is I am allergic to Dihydrocodeine.  I think it was Co-Proxomal that did nothing for me after a hysterectomy.  I was in terrible pain and they took me of the morphine pump because I was sick and itching and gave me these tablets.  

I do not have severe Asthma but I thought Ibroprufen should not be used on Asthmatics.  

I wondered if it might be worth me talking to my local pharmacist for advice on pain relief after this surgery?  

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16 Replies

  • Posted

    Hi  gilly64037.

    I have just read your comment re pain relief ahead of your surgery.

    I also live in uk and had both feet done ( 2013 and 20140 with huge success.)

    I think you may be 'jumping the gun' a bit re the pain relief.

    You may not even have pain from the surgery. Not everyone does. I certainly didn't. Just huge amounts of swelling and throbbing. Both of which are greatly relieved if you make sure you stay off your feet for 50 minutes out of each hour and, keep the foot/feet elevated above groin or heart level as much as possible especially in the first two weeks after surgery and thereafter as much as possible.

    This is the key to successful post surgery healing.

    I was sent home from my hospital with Tramadol and Ibuprofen. Both were administered to me whilst in hospital but the Tramadol was wholly responsible for making me very sick and dizzy. Once I stopped taking Tramadol the symptoms disappeared. I kept on with the Ibuprofen and Paracetamol taken together for a further 2 weeks just as a precaution. As mentioned earlier I actually didn't have any pain so the Tramadol was obviously given to me as a precaution in case there was pain once the pain block injected into my foot at  the end of surgery had worn off. This usually takes between 24 and 36 hours.

    Speak to your consultant/surgeon/ anaesthetist who will all ( or should) give you lots of helpful advice about what's going to work best for you.

    I am sure you will join the ranks of most of us who have had this surgery and have a virtually pain-free experience.

    Good Luck.


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    • Posted

      Thank you for your very supportive advice it really helps.  Did you actually have the Lapidus Procedure?  

      Mine is that plus the next two hammer toes straightened. My surgeon said no two patients are the same when it comes to pain.  I just want to make sure I can get something ready - not - after the event find myself in so much pain I am trying to get to see a GP.  It is probably my past experience of non-adequate pain reilief that is making me pro-active now.

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    • Posted

      Hi Gilly.

      I had scarf and akin osteotomy.

      I also had a 2nd toe hammertoe attended to on my left foot in 2013 when I had the bunion correction done.

      With the hammertoe procedure I had a K-wire inserted for 6 weeks whilst the toe healed internally.

      I wore a heel wedge shoe also following this surgery and the surgery in 2014.

      I also had elbow crutches which I found a great help in the early weeks and for use when outdoors or shopping etc.

      I invested in a bed cradle to insert between the base and mattress of my bed to keep the bedclothes off my feet whilst sleeping.

      I also invested in a Limbo  -  which is a plastic stocking designed for wearing to protect the bandage or plaster cast whilst showering or bathing. These Limbos come in various lengths depending how much of your limb you wish to keep dry.

      I found both these purchases worthwhile and both did exactly the job they were designed to do.

      Both are available online or at specialist mobility supply shops ( where I bought my bed cradle).

      I bought my Limbo online.


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  • Posted

    I live in the US I have been taking Tylenol #3 but that has ,codeine in it I also have asthma and have had no problems taking ibuprofen i did not have same surgery your havinh mine was little more simple did have a hammer toe fixed screw put in place and bunion removed and bones fixed and everyones pain tolerance is different i for one have a high pain tolerance so I dont need much pain relife
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    • Posted

      Thank you for reply Rebecca.  Why I wrote UK as part of my 'heading' is because over here some medication is not available and I suppose visa versa.

      Yes pain tolernace is different for everyone I agree.

      Just out of interest - here is something - I copied and pasted:

      What Are the Risks for People with Asthma?

      If you have asthma, painkillers called nonsteroidal anti-inflammatory drugs (NSAIDs) can be risky. They include aspirin, ibuprofen, naproxen, and ketoprofen, the active ingredients in medicines like Bufferin, Advil, and Aleve.

      I am pleased you are OK taking it and felt i needed to look into taking 400mg before the op.  Thank you again.

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  • Posted

    Hi Gilly

    I am a nurse and you are right asthmatics should not take NSAIDs. Can you take Codeine? I had this with paracetamol, I did need to increase dose of Codeine from 2 to 4 tablets just for the first 48hours.


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    • Posted

      Thank you for your help.  I have just emailed the secretary for the surgeon and explained my concerns re: pain relief especailly with the lapidus procedure.  

      As I said Co-Proximal was useless after Hysterectomy.  After breast cancer surgery (wide local excision) I can't rembember what they gave me.  I think I can remenber a combination and one was Tramadol but this was not as painful as previous surgery.

      I will let you know if I get any feedback from Hospital.

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  • Posted

    Put aside your worries about drugs, you may not need them. I cant' take any  presecription pain meds at ALL; Codeine and Morphine based meds make me so ill. I don't have asthma, and am in the UK, not the US, but i would like to reassure you that pain management need not be a worry. During the first week I took only sporadic, alternating doses of paracetamol (= regular tylenol i think) and ibuprofen - (400 mg), and did not need anything stronger. This is my second bunion surgery in two years.I have lots of stitches, two incisions,  two pins and a staple this time. I am four weeks on, and have had no pain worse than a dull ache or occasional sharp stab as the bones heal and nerves regenerate. I try to view these fleeting pains as a positive, not a negative. The surgeon/anesthetist should give you a nerve block during surgery which will stop you feeling much discomfort the first 24 hours. After that  rest and elevation is the best way to recover.  The most motivating part of the healing process for  me is that my feet have always had less pain after the first week to10 days following surgery than they did previously with Bunions! Good luck in July!
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    • Posted

      Did you have the Lapidus procedure Alice?  

      My problem is my bunions do not hurt - it is a case of my feet being really deformed and the surgeon said it can get worse.  At 70 years of age in July I feel I either have this operation now or forget it.  

      Looks like Ibuprofen would be very helpful but can't have it.

      Thank you for wishing me Good Luck - date racing ahead - amazing if it was something i was looking forward to it would drag but not this!


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    • Posted

      Yes, I had the Lapidus, and my NHS local health authority would not have carried out bunion surgery at all if my feet were not hurting all the time. This is partly because of cost, and partly because there is a risk you can have permanent discomfort / aches following bunion surgery. If it isn't painful, NHS treatment  is non-surgical - wear toe separators and/or orthotic shoe inserts. Is your surgeon private?

      Age is a concern, especially with foot healing. it can be prolonged. I imagine you are in good health, and still quite mobile in spite of the deformity caused by your bunions?  I am 50. My grandmother ended up with seriously limited mobiliity from failing to have her painful bunions surgically corrected at an age when the recovery and improvement prospects were better. Mobility problems led to a general decline in  her fitness, and then her health. That of course may be why your surgeon is recommending you have the operation, but I  just can't understand his/her putting you through this if you have no pain and are not showing signs that the deformity is limiting your mobility? 

      I jumped at the chance to get my feet corrected. I am happy I had it done, but would not have gone through it if my feet did not hurt or for cosmetic reasons.

      I don't want to cause you concern, but have you had a second opinion about the necessity of surgery - weighing up the possible benefits from the risks?

      It must be hard to see your op date approaching from a distance at a snail's pace. I went into both my procedures with less than 3 weeks notice -  just enough time to prepare/sort out work issues and home responsibilities, but not enough time to dwell or worry!

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    • Posted

      Thank you Alice and I appreciate you are trying to be helpful.  In a way I feel I could say I have had two opinions - both NHS.

      In 2006 - I saw NHS Consultant Orthopaedic Surgeon (also Foot and Ankle Surgery).  His words in his letter to my GP -

      'this woman had bilateral bunions which are at present causing her nothing more than foot problems.  She has some metatarsalgia due to lateral transfer of the weight because of her bunion.  At present she is not keen on surgery but I think over the course of time however she will require surgery and I will review her again in 6 months time.'

      At this appointment I asked him what shoe inserts, etc, etc he would recommend and he said it will not help you.

      Then 2007 - I get breast cancer - so in remission and thought I will have another thought as I have it done now or forget it.

      2015 - July - I went to a Poediatric Surgeon and asked his opinion again on NHS.

      I asked what are the chances that my foor deformity becoming even more severe if I do not have surgery?

      His answer is 100% particularly with family history.

      Conclusion - because of no pain (mind you I have on occasion had cramp under my foot and also like a nerve pain at the top of a 'good' toe) I too feel the decision to go ahead is made harder because I am not in pain.

      I do get pain under the 'ball' of my foot and the first surgeon said I would because the 'padding' has gone if I recall his words correctly. 

      So - it seems two NHS surgeons are willing to take me on and it could be because of the deformity of my feet already.


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    • Posted

      Sorry if this sounded confusing -

      2006 - Saw first consultant.  Actually had appointment come through to see him again but was then into breast cancer in 2007.  Three years continuous treatment.

      2015 - Do I have it done?  Made appointment with NHS Surgeon that did this surgery all the time and for a Private Hospital.

      So - now or never - really.

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    • Posted


      i was told before my surgery, that the recovery time for me at 60, would be no different to me at 80. The only thing I had to consider is lapidus & Atkins within 2 years, or something extremely major,if it could be done, after that time slot. I didn't have the choice.


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    • Posted

      Thank you Caroline for that information so at 70 - I am taking the middle road! wink

      Sorry I am not sure what you mean by ' The only thing I had to consider is lapidus & Atkins within 2 years, or something extremely major,if it could be done, after that time slot. I didn't have the choice.'

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    • Posted

      Sorry Gilly,

      My extreem 'bunions' had to be operated on within 2 years, otherwise they would have had a major impact on the other 4 toes and effect my walking.

      They were very painful, and were tending to become infected when i walked any distance, which would keep me off work with a high fever. I was also starting  to limp, which threw my balance of true, which in turn was hurting my back. wheels within wheels, so i had the choice of - get your feet done asap or suffer even more.

      Both were done at the same time, as they were equally bad.


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    • Posted

      Poor you!  Your only option was to go ahead wasn't it - fancy having them both done at the same time. ouch!

      If my bunions were painful it would not be so bad.  Having said that I dont know what they would feel like if I wasn't retired i.e. on my feet all day and wore close fitting shoes.


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