Morton's Neuroma
Discussion
Over the last few months I have had increasing pain and a burning sensation in the 3rd and 4th toes of my left foot. I have seen a specialist who has indicated that my symptons are classic examples for Morton's Neuroma and I have an MRI scan booked for today to confirm the diagnosis.
The specialist has indicated that there are two options to cure this. One is using Cryogenics (sp) to freeze the growth out and the other is surgery under a General.The Cryogenic method is not guaranteed to prevent it occurring again so I will probably go for the surgery option.
Has anyone had this before and if so how long did it take you to fully recover. My main concern is that I am a keen skier and want to be able to wear my boots without too much discomfort this season.
Any comments/experience much appreciated.
The specialist has indicated that there are two options to cure this. One is using Cryogenics (sp) to freeze the growth out and the other is surgery under a General.The Cryogenic method is not guaranteed to prevent it occurring again so I will probably go for the surgery option.
Has anyone had this before and if so how long did it take you to fully recover. My main concern is that I am a keen skier and want to be able to wear my boots without too much discomfort this season.
Any comments/experience much appreciated.
Depends when you intend on going Skiing. If it's early in the season then you might struggle.
Can't see why you need a general for a neuroma. Surely a tibial block would do it? Worth asking the question.
Other thing to try is a metatarsal dome under the balls of the affected foot. Theory being it spreads out the met heads a bit and that can relieve the symptoms. Is this specialist an orhtopedic surgeon?
If so it might be worth getting a second opinion from a podiatric surgeon. They only do feet, nowt else.
Can't see why you need a general for a neuroma. Surely a tibial block would do it? Worth asking the question.
Other thing to try is a metatarsal dome under the balls of the affected foot. Theory being it spreads out the met heads a bit and that can relieve the symptoms. Is this specialist an orhtopedic surgeon?
If so it might be worth getting a second opinion from a podiatric surgeon. They only do feet, nowt else.
Management depends a lot on how long this has been developing. There are some excellent outcomes from conservative measures - orthotic management combined with an effective stretching program can be very helpful. Looking at your day to day shoes to ensure that your foot is not overly compressed, yet supported properly.
Sometimes local injection of a cortico steroid can reduce symptoms effectively too.
high definition ultrasound imaging is often considered the most effective imaging modality, although MRI is effective too.
I have not found the evidence for cryo treatment compelling enough to explore, when push comes to shove excision and biopsy are a good option, typically this can be done under local anaesthetic as a day case, but it still takes several weeks to recover fully. No treatment is 100% guaranteed.
I had an episode of neuroma pain about 15 years ago, It lasted for a couple of months, but with more attention to footwear and long term use of the best quality orthotics I could find it has been pretty much trouble free ever since. Although I went to buy new skiboots a couple of years ago (my raichle flexons finally died) and I tried on a boot that was too small - my foot was painful for 2 weeks!
You should revisit your ski boot fitting. It might be worth looking at fitting an orthotic to your ski boots. Many skiboot fitters are good at this (particularly in North america - May also be in europe, but I have no experience of this)
Sometimes local injection of a cortico steroid can reduce symptoms effectively too.
high definition ultrasound imaging is often considered the most effective imaging modality, although MRI is effective too.
I have not found the evidence for cryo treatment compelling enough to explore, when push comes to shove excision and biopsy are a good option, typically this can be done under local anaesthetic as a day case, but it still takes several weeks to recover fully. No treatment is 100% guaranteed.
I had an episode of neuroma pain about 15 years ago, It lasted for a couple of months, but with more attention to footwear and long term use of the best quality orthotics I could find it has been pretty much trouble free ever since. Although I went to buy new skiboots a couple of years ago (my raichle flexons finally died) and I tried on a boot that was too small - my foot was painful for 2 weeks!
You should revisit your ski boot fitting. It might be worth looking at fitting an orthotic to your ski boots. Many skiboot fitters are good at this (particularly in North america - May also be in europe, but I have no experience of this)
Edited by sawman on Tuesday 15th November 19:55
I had one a few years ago. I was reffered first to orthotics and they gave me special insoles for my shoes - no good at all. Then the consultant gave me an injection of lidocaine into the neroma - now that is what I call pain (I found childbirth easier!). This helped for a while but didn't solve the issue.
Finally after suffering for nearly 1yr I eventually had it surgically removed. This was amazing - I go in on cruthes due to the pain, and come out a few hours later in far less pain than I had been suffering for the past year. I found the recovery very quick and painless. I was back to work in two weeks (physical job, on my feet the whole day), and have never looked back.
Hope you get it sorted quickly, and are soon pain free.
Finally after suffering for nearly 1yr I eventually had it surgically removed. This was amazing - I go in on cruthes due to the pain, and come out a few hours later in far less pain than I had been suffering for the past year. I found the recovery very quick and painless. I was back to work in two weeks (physical job, on my feet the whole day), and have never looked back.
Hope you get it sorted quickly, and are soon pain free.
UPDATE
After speaking in depth to the Specialist and doing some research I decided to go straight for surgery and have the thing removed.
Operation was done last Wednesday under a General but I was in and out the same day. Pain is easily being controlled with just a couple of paracetamol each day and I have one of those lovely surgical shoe things to wear for a couple of weeks. I am using crutches but can now begin to put a little weight on my foot without too much discomfort.
I was a little surprised to find that the Specialist had come in from the underside of the foot rather than the top but he said it was less intrusive that way (?)
Not sure when I will be able to drive my car (manual) but as it is the Xmas period I think I will make the most of it.
Anyway the next planned ski trip is in 9 weeks time and I am optimistic that I should be fine by then.
Regards
Dave
After speaking in depth to the Specialist and doing some research I decided to go straight for surgery and have the thing removed.
Operation was done last Wednesday under a General but I was in and out the same day. Pain is easily being controlled with just a couple of paracetamol each day and I have one of those lovely surgical shoe things to wear for a couple of weeks. I am using crutches but can now begin to put a little weight on my foot without too much discomfort.
I was a little surprised to find that the Specialist had come in from the underside of the foot rather than the top but he said it was less intrusive that way (?)
Not sure when I will be able to drive my car (manual) but as it is the Xmas period I think I will make the most of it.
Anyway the next planned ski trip is in 9 weeks time and I am optimistic that I should be fine by then.
Regards
Dave
Little Dave said:
...........
I was a little surprised to find that the Specialist had come in from the underside of the foot rather than the top but he said it was less intrusive that way (?)...........
It will be interesting to see if that approach leaves you with any future problems. You may be walking on a scar and scar tissue isn't designed to be walked on, if you see what I mean.I was a little surprised to find that the Specialist had come in from the underside of the foot rather than the top but he said it was less intrusive that way (?)...........
It would be worth asking the doc about it though and see if they have any regime in place to avoid problems. I'm thinking about the cases I've seen of people developing hypertrophic lesions/keloid scars at incision sites. Leaves you with a nuisance lump of rock hard skin to walk about on....sometimes.
Have fun skiing anyway.....sods law, you break your other leg off on the 1st day and be laid up for 6 months....snigger...
) Quick update to close the thread
3 weeks in and very little discomfort. I am back driving a manual car with no problems and walking with only a very slight limp now and again. I am confident that I could ski next week so really happy about that. The stitches have all now dropped out and am left with a scar about 4cm long. The best thing though is no searing pain shooting through my toes.
Very pleased I went the surgery route and grateful for all of your comments.
Happy New Year to you all.
3 weeks in and very little discomfort. I am back driving a manual car with no problems and walking with only a very slight limp now and again. I am confident that I could ski next week so really happy about that. The stitches have all now dropped out and am left with a scar about 4cm long. The best thing though is no searing pain shooting through my toes.
Very pleased I went the surgery route and grateful for all of your comments.
Happy New Year to you all.
Thought I would dig this topic up again.
I went skiing 9 weeks after the op and all went well for 4 days. The left foot held up really well with no problems at all but on the 5th day I got a familiar pain shooting through the toes of my RIGHT foot. To cut a long story short I am back under the knife next Wednesday (15/8) to have my right foot done. I have requested this time that the surgeon goes in from the top side and not the sole. I should be an expert on these Neuroma soon!
I went skiing 9 weeks after the op and all went well for 4 days. The left foot held up really well with no problems at all but on the 5th day I got a familiar pain shooting through the toes of my RIGHT foot. To cut a long story short I am back under the knife next Wednesday (15/8) to have my right foot done. I have requested this time that the surgeon goes in from the top side and not the sole. I should be an expert on these Neuroma soon!
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