Who is Mr Shelain Patel?

Mr Shelain Patel (BSc, MBBS, DipSEM, FRCS) is a consultant orthopaedic surgeon who works exclusively on foot and ankle conditions in London and Stanmore. He is one of only four foot and ankle surgeons at the Royal National Orthopaedic Hospital, the UK's top rated orthopaedic institution.

What conditions does Mr Shelain Patel treat?

He treats the full range of foot and ankle disorders including ankle sprains, ligament damage and instability, ankle arthritis and cartilage injuries, Achilles tendon tears and pain, bunions and big toe arthritis, flat feet and tibialis posterior tendon dysfunction, plantar fasciitis and heel pain, Morton's neuroma, foot drop following nerve and spine injuries, congenital and complex acquired deformities, and trauma including osteochondral lesions.

What surgery does Mr Shelain Patel perform?

Procedures include bunion correction, ankle replacement, ankle fusion, keyhole ankle arthroscopy and microfracture, Broström-Gould ligament repair, Achilles tendon repair and Haglund excision, big toe replacement and fusion, Morton's neuroma excision, flat foot and cavus foot reconstruction, minimally invasive metatarsal osteotomy, and tibialis posterior tendon transfer for foot drop. Only about one in three consultations leads to a discussion of surgery.

Where does Mr Shelain Patel practise?

His private practice is in the Harley Street district of Central London at HCA Princess Grace Hospital and King Edward VII's Hospital, and in North London at Spire Bushey, Elstree Waterfront and RNOH Private Care in Stanmore. The consultation address is 30 Devonshire Street, London, W1G 6PU.

How do I book a consultation with Mr Shelain Patel?

Consultations can be booked by contacting his secretary on 020 3960 1705 or by email at patelpa@gop.health. He accepts both private medical insurance and self pay patients.

Does Mr Shelain Patel offer second opinions?

Yes. Through his role at the Royal National Orthopaedic Hospital he provides specialist second opinions for patients facing complex foot deformity or who have had unsuccessful previous treatment.

Bunion Treatment in London | Mr Shelain Patel, Consultant Foot & Ankle Surgeon

Q: Is bunion surgery painful?

Modern bunion correction is generally well tolerated. Pain is managed with local anaesthetic blocks and oral medication.

Q: What is the difference between minimally invasive and open bunion surgery?

Minimally invasive surgery uses small incisions for less soft tissue disruption. Open surgery gives more direct visual control and is preferred for severe deformities.

A Patient's Guide

A bunion (hallux valgus) is a bony bump that forms at the base of the big toe when the toe joint shifts out of alignment, pulling the big toe towards the smaller toes. Bunions are progressive, often worsen without treatment, and range from mild cosmetic changes to severe deformity causing chronic pain and difficulty walking.

Mr Shelain Patel is a consultant orthopaedic foot and ankle surgeon based in London, treating bunions at all stages — from conservative management through to minimally invasive and open surgical correction — at HCA Princess Grace Hospital (Harley Street), HCA Elstree Waterfront, and the Royal National Orthopaedic Hospital (RNOH).

Symptoms and Signs

There are some classical symptoms and signs which include:

Physical Appearance: One of the most noticeable signs of a bunion is the physical appearance of a bump on the side of the foot at the base of the big toe. This bump can vary in size and is typically more prominent when wearing tight or narrow shoes. The big toe may also lean towards the other toes, sometimes overlapping the second toe.
Pain and Discomfort: Pain and tenderness are common symptoms associated with bunions. The pain is often localised to the joint at the base of the big toe and can be exacerbated by prolonged walking, standing, or wearing ill-fitting shoes. Some individuals experience chronic pain, while others may have intermittent discomfort.
Swelling and Redness: Inflammation is another hallmark of bunions. The area around the bunion may become swollen and red, contributing to the overall discomfort. This inflammation is often due to the friction and pressure from footwear, leading to irritation of the skin and underlying tissues.
Restricted Movement: As the bunion progresses, it can cause a decrease in the range of motion of the big toe. This restriction can impact walking and other activities that require bending or flexing of the toe. Over time, this limited mobility can lead to further complications, such as joint stiffness and arthritis.

Assessment

Diagnosing bunions involves a combination of clinical evaluation, imaging studies, and sometimes laboratory tests. A medical history requires details about the onset, duration, and intensity of symptoms, whilst examination will assess range of motion, swelling, tenderness, bony growths, and walking. Investigations include:

X-Rays/Standing CT: These imaging modalities provide detailed images of the bones and joints in the foot, allowing evaluation of the alignment of the bones, the extent of the deformity as well as associated arthritis or joint damage.
Magnetic Resonance Imaging (MRI): In some cases, an MRI may be ordered to provide a more detailed view of the soft tissues, including cartilage, tendons, and ligaments around the joint. This can help assess the extent of cartilage damage and detect any associated conditions in complex cases.
Gait Analysis: Rarely, gait analysis is used which is an assessment of how a person walks and can provide valuable insights into the biomechanics of the foot. This analysis can help identify any abnormalities in foot motion that may be contributing to the development or progression of a bunion. Gait analysis is typically performed using specialised equipment and software to capture and analyse the patient’s walking patterns.

Conservative Treatment

Treatment for bunions aims to relieve pain, improve function, and slow the progression of the disease. The treatment plan can vary depending on the severity of symptoms and the degree of joint damage. Options include:

Footwear Modification: One of the first steps in managing bunions is to change the type of footwear. Shoes with a wide toe box, good arch support, and cushioned soles can help reduce pressure on the bunion and alleviate pain. Avoiding high heels and shoes with narrow toes is also recommended.
Medication: Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen can help reduce pain and inflammation.
Orthotics: Splints or toe spacers can separate the toes. Splints can be used at night to relive symptoms in the morning whilst toe spacers can be used during the day if footwear allows.
Activity Modification: Avoiding activities that exacerbate pain, such as running or jumping, and opting for low-impact exercises like swimming, cross-training or cycling can help manage symptoms. Regular physiotherapy exercises can help strengthen the foot muscles and stretch stiff joints.

Surgical Treatment

Surgery is considered for around one in three symptomatic bunion patients, typically when conservative treatment has failed or deformity is severe. Options will depend upon your goals and the severity of disease:

Osteotomy: This surgical procedure involves cutting and realigning the bones in the foot to correct the deformity, and can provide a more permanent solution for severe bunions. This procedure is often performed in conjunction with a bunionectomy (removing excess bone) and a release of soft-tissues. Options can include minimally invasive surgery, or open surgery with the decision about which to proceed with depending upon the practice of the surgeon, and the patient's bone morphology and deformity. New techniques to de-rotate the metatarsal is performed when there bone is identified as being twisted.
Arthrodesis (Joint Fusion): Arthrodesis, or joint fusion, is a surgical option for severe bunions associated with arthritis. This procedure involves fusing the bones of the big toe joint to eliminate pain and improve stability. While arthrodesis can limit joint movement, it can provide significant pain relief and improve overall foot function.

Frequently Asked Questions

Do bunions go away without surgery?

No. Bunions are a progressive bone deformity and will not reverse on their own. Conservative treatments — wider shoes, orthotics, toe spacers — can relieve pain and slow progression, but only surgery corrects the underlying bone misalignment.

How long does bunion surgery recovery take?

Most patients are in a protective boot for around six weeks, with a gradual return to normal shoes by ten to twelve weeks. Full recovery, including resolution of swelling and return to high-impact activity, can take four to six months depending on the procedure used.

Is bunion surgery painful?

Modern bunion correction minimises soft-tissue trauma and this minimises pain. Pain after surgery is managed with local anaesthetic blocks and oral medication, and most patients describe the discomfort as manageable and less than they expect.

What is the difference between minimally invasive and open bunion surgery?

Minimally invasive surgery uses small incisions and specialised instruments to realign the bone. Open surgery (such as a scarf osteotomy) gives the surgeon more direct visual control and is preferred for more complex or severe deformities. The right choice depends on the degree of deformity and bone shape, assessed on X-ray or standing CT.

Where can I see Mr Shelain Patel for bunion treatment in London?

Mr Patel sees private patients at HCA Princess Grace Hospital in the Harley Street area of Central London, HCA Elstree Waterfront in North London, and provides specialist second opinion care at the Royal National Orthopaedic Hospital (RNOH), Stanmore.

Summary

Bunions are a common foot condition that can cause significant pain and discomfort. Early diagnosis and treatment are essential to manage symptoms and prevent the progression of the deformity. Conservative treatments, such as footwear modifications, orthotic devices, and physical therapy, can provide relief for many individuals. However, in severe cases, surgical intervention may be necessary to correct the deformity and improve quality of life. Consulting with a healthcare provider who has experience of managing this condition such as Shelain Patel, can help determine the most appropriate treatment plan based on the severity of the bunion and the patient’s individual needs.