Pain in the forefoot can range from tingling and burning to a dull ache or throb.  The majority of forefoot pain can be broken down into nerve pain ie a neuroma or mechanical pain ie capsulitis.  Both can cause similar type symptoms and differentiating between the two can be difficult. 

Capsulitis is the most common forefoot type of pain.  It is basically an overloading of the metatarsal phalangeal joints.   Most patients will experience a combination of burning and aching.  There are many causes of forefoot capsulitis or overloading.  This can be from tight muscle groups or abnormal anatomy.  The majority of patients will find conservative therapies successful and will completely recover.

Neuromas usually occur in a specific anatomical location, the 3^rd interspace.  This pain is almost exclusively a burning or tingling.  It is almost always worse with shoes and primarily affects females.  Neuromas occur from irritation to the nerve that is mechanical or anatomical in nature.  Again the conservative success rate for this is high.

If you are experiencing burning or tingling in the foot I can help.  I have an exceptional protocol for both capsulitis and neuritis.  If you have foot pain, call today.

Sincerely,

Dr. Brandon Nelson

Bunion surgery is one of the most common procedures performed in the United States.  It is almost exclusively done in an outpatient setting and the majority of procedures can be completed in less than 2 hours.  Most patients will experience pain that lasts a few days and can begin weight bearing fairly soon.  There are many different types of bunion surgery and not all are equally effective. 

There are a few things that will help patients get a better outcome with bunion surgery.  I will discuss these tips that can be helpful along with selection of the surgeon.

#1. The most important thing after having any type of surgery is to follow postoperative protocol.  There are many tips that can improve your outcome after bunion surgery and careful adherence to postoperative protocols is essential.

#2. Bone healing supplementation, there are many different types of bone healing supplementation that are not all created equal however some of them can be highly effective in decreasing healing times.  I have a brand that I recommend for all my patients that often shaves weeks off of healing time.

#3. Couch potato for your first week, set yourself up for success.  During that first week just really take it easy, take your medications as prescribed, ice and elevate your foot.

#4. Surgeon selection, the majority of us have very similar training and most foot and ankle physicians are highly trained in this procedure.  One question I would ask any surgeon is how many bunion surgeries they perform annually.

I hope this is helpful and can be utilized by you in the future.

Sincerely,

Dr. Brandon Nelson

Heel pain can be very challenging no matter when it occurs.  It can be common in the morning or after exercise.  There are many causes of heel pain and the most common is plantar fasciitis.  Plantar Fasciitis is a condition in which the plantar fascia in your foot becomes inflamed. 

An inflamed plantar fascia is often characterized by burning or a bruised type sensation one's heel.  Many patients describe the fact they feel like they are walking on a marble or pebble.  This can get worse as time and activity levels go on and can become quite debilitating.  This can be brought on by many causes but most notable is overuse.

Overuse is by far the most common cause.  Patients often relate the start of a new exercise program or a new activity.  This new activity can put new stresses on your fascia which ultimately leads to inflammation and pain.  It is always best to ease into activities as this can help minimize fascial pain.  Another key characteristic of facial pain is morning stiffness or irritation.

Morning pain is a hallmark of fasciitis.  This is very common and one of the most challenging parts of having plantar fasciitis.  This is often because when you sleep and then step down on your foot your fascia instantly becomes irritated.  This can be extremely difficult to get rid of and often sticks around for months.  This is when it is time to make an appointment with a heel pain specialist.  I have been treating heel pain for 15 years and can help you get rid of it quickly.  Give us a call today at 425-391-8666 or make an appointment online today. 

Sincerely,

Dr Brandon Nelson

I have been operating on bunions now for over 15 years and have performed 1000’s of bunionectomies.  I continue to enjoy working on bunions as the surgical results are satisfying for both the patient and physician.  Bunions come in all sizes and present in all ages from teenagers to adults.  Many patients seek out care for bunions and some choose to have them fixed.  It is important to note that not everyone is a surgical candidate and not every bunion requires surgical intervention. 

Surgical care for a bunion can provide excellent results.  One of the most common procedures is the Lapiplasty bunionectomy.  It has shown exceptional follow up and long term outcomes.  I find the Lapiplasty to be very reproducible and have high patient satisfaction.  It is not appropriate on every patient nor is it the only bunion procedure I find highly successful.  

My office has an onsite surgical center that we utilize for bunion surgery.  It is a significant cost savings and time savings for patients.  It utilizes monitored anesthesia care with a nerve block of the lower extremity.  If you have a bunion and would like a consultation please feel free to call the office at 425-391-8666 or schedule an appointment online.

Sincerely,

Dr Brandon Nelson

After years of experience and 1000s of bunion surgeries I have taken some time to reflect back on different techniques and procedures.  I have seen new products and new surgeries come in and out of fashion.  Every few years a new health care company will introduce fancy new products that they want us surgeons to utilize.  I have seen many new instruments and new ideas that are supposed to revolutionize outcomes and provide time and cost savings.  It is interesting that things seem to always come back to the tried and true techniques that have been around for years. 

The two most prolific bunion correction surgeries are the Lapidus and Austin bunionectomy.  These two procedures have been around for years and have corrected 100’s of thousands of bunions.  They continue to be the work horses of bunion surgery as they have predictable outcomes and long term follow up.  I utilize both and have found the majority of bunions have great correction when one of these two techniques are used. 

There is currently a lot of buzz around the Lapiplasty procedure and for good reason.  It employs a surgical technique, the Lapidus, that has been around for almost 100 years.  This procedure was brought to the forefront by a Surgeon in Seattle named Sigvard Hansen.  Dr Hansen has since retired and is considered by many to have been a pioneer in the field.  Some of us were lucky enough to spend time with him and learn his techniques and continue to utilize the Lapidus bunionectomy.  The Lapiplasty is a tool kit that helps surgeons perform this procedure.  It has helped to make outcomes more reproducible and simplified the technique. 

The Lapiplasty is one of my most common procedures and I find it to have predictable and reproducible outcomes.  If you have a bunion and would like to see what kind of candidate you are please contact my office and I would be happy to help. Give us a call at 425-391-8666 or make an appointment online today. 

Sincerely,

Dr Brandon Nelson