While surgery is successful in many cases, the reported long-term outcomes of neuroma excision vary. Surgery is reasonable if conservative treatments such as foot orthotics, shoe supply such as butterfly insoles, foot exercises and self-massage or injecting local anaesthetics cannot provide long-term pain relief. I kept my foot elevated and enjoyed some solid couch time. Remove the diseased portion of the nerve, or. Burning pain in the ball of your foot that shoots into the toes. This is called decompression. The majority of people with Mortons neuroma are able to find relief with conservative treatments, which may involve a change in footwear (wearing shoes with wider, stiffer soles that are well padded and low heels), custom orthotic therapy, physical therapy, nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroid injections, alcohol injections, or a combination of these therapies. Most patients who undergo a Mortons neuroma excision, in which the neuroma and part of the nerve are removed, will experience complete relief from pain but will suffer some permanent numbness of the adjacent toes. This past Friday, January 8, 2016, I had surgery on my right foot to remove a Morton's Neuroma that has plagued me for nearly a decade. Recurrences are considerably more likely after amputating the nerve (neurectomy), as this does not remedy the underlying deformity of the arch. Do you have Mortons Neuroma and decided that you want to have it surgically removed? Formal rehabilitation is not usually necessary. In my practice, I'd wager less than 5% of suffers with a TRUE Morton's neuroma (it is frequently misdiagnosed) fail to respond to *something* and elect to undergo surgery (either decompression or nerve resection). Last week, a friend of mine was telling me that she had her Neurectomy 4 months ago (Early June 2019). The dressing holds the foot securely in place, much like a cast, to allow healing. Ice Pack / Rub. During your inpatient and outpatient stay our multi-lingual (English, Russian, Spanish, Portuguese) case management team will be there to assist you. I saw another local foot/ankle doctor and we came to the conclusion that I had incurred a small bit of Achilles tedonitis most likely from wearing zero drop shoes while modifying my gait to avoid putting pressure on the surgical area. Both procedures take about 30 minutes. The wound may be closed with an absorbable suture or with stitches, and the foot is wrapped in a compressive dressing. 2. Nerve sclerosis with alcohol injectionsno help whatsoever. Plantar (underside) and dorsal (topside) views of the foot showing a Morton's neuroma (circled) in the third web space. Call our friendly team today on 020 3195 2442. Here are simple techniques which may help you: Thank you very much for reading. A neuroma is a thickening of nerve tissue that may develop in various parts of the body. Podometry (foot pressure measurement) is also helpful to measure the pressure distribution under the bottom of the foot. It was nice to only be in the boot a few days. I did the spinning with the pedal placed in the arch of my foot to avoid putting too much pressure on the ball of my foot. How is Morton's neuroma surgery performed at Gelenk-Klinik? Very interested to see how you have fared since your last update since I've had a hard time finding reports from distance/ultra runners on how it's worked out for them. Can't find doctor i trust. If they dont help, you can have your neuroma removed. Approximately 5 to 20% of patients may have symptoms return and need additional treatment. However, there are also significant cases (30%+) in which surgery, especially neurectomy, has not yielded desired outcomes. The sutures will be removed after about 10 days. ", Mr. H. (44), Egypt, knee and spine patient: "The clinic to me is a comfort zone where I feel pure professionalism and experienced specialists", Inflammation in any of the joints between the metatarsal bones (bones of the forefoot) and the proximal phalanges (bones at the base of the toe), Stress fractures in any of the metatarsal bones, Soft-tissue changes, including scars, warts and tumors, Improper weight distribution as in the case of pronounced splayfoot, less scarring, thus less irritation to the nerve of the foot after surgery, saving the nerve of the foot, which can be symptom-free (free of pain) and function normally after the nerve sheath swelling has gone down, lower tendency of recurrence: relapse due to recurrence of painful swelling is common, lower tendency of developing permanently painful scars around the metatarsal nerve, Earliest return flight: 3 days after surgery, Recommended return flight: 5 days after surgery, Showering permitted: 10 days after surgery, Time before being able to drive again: 45 weeks. I have Morton's Neuroma, and something that has helped me a lot over the last several years ( I have not had surgery for it ) is simply NOT WEARING SOCKS and wearing shoes with a nice, wide toe box. I'm now three weeks post-op for surgery to remove a damaged nerve in my foot. Before the surgery, you may be given some form of sedative anesthesia, and a local anesthetic will be injected into the affected area of the foot. Apart from discussing the medical history and a physical examination, this includes MRI images in prone position with contrast agent and in x-rays standing. I got used to it. There may be numbness or an unpleasant tingling in the toes. Ten days post-op I went rock climbing again, using bigger, more comfortable climbing shoes and this felt very reasonable. If the personal quality of life has been reduced and pain is severe, and if conservative treatment is unsuccessful, surgery is an option. I am 20 days post op. I haven't tried the Topo shoes but they look promising. The pain is caused by the thickening tissue around the nerve. Finally 7 days out from a pretty good surgery and in the funky post op black shoe that is pretty much the foots equivalent of a vasectomy! Theyre certified foot and ankle surgeons whose continuing education, diagnostics and surgical quality is reviewed annually by an independent German professional society (DAF). Altra shoes don't work for me because they're zero drop and that beats up my achilles and posterior tibial tendons. I'll update this again in a few weeks with a report once I've been able to run longer. But really I'm very pleased with the recovery thus far. The pain is so severe that patients will only experience temporary relief by sitting down or taking off their shoes. Site Map. The Best Shoes for Morton's Neuroma. We have been seeing excellent medical results for years by relieving the nerve and possibly decompression by repositioning the metatarsal bones. The anaesthetists at Gelenk-Klinik are very experienced in both methods and will choose the option best for the patient and their circumstances based during a pre-operation discussion. 2 months out of surgery and most of the swelling is gonebut if I lightly press on the metatarsal bones beneath my foot they feel very bruised (which I'd way rather take over nerve pain but still an annoyance). Advanced imaging, such as an MRI, may be necessary in certain cases, but this is often not needed. If you chose the nerve decompression procedure, you can expect to get back to work almost immediately with comfortable shoes. Sprinters may feel pain as they push off from the starting block. These noncancerous nerve tumors typically respond well to current therapies such as orthoses, injections, or surgery. Every time you step on the foot, you'll most likely feel a stabbing sensation, possibly with tingling or burning. Thanks for the comment coldsoil! Copyright 1995-2021 by the American Academy of Orthopaedic Surgeons. It is similar to a ganglion cyst, which occurs usually around the wrist. Formication or a feeling of numbness in the toes are symptoms of Morton's neuroma. Hi jwood. You can do Ultrasound Guided Platelet Rich Plasma Injections. Similar to cryosurgery for Morton's neuroma, Cryosurgery treatment of bursae, usually results in a small patch of numbness at the base of the toes and of the two toes of the affected metatarsal interspace. Nerves of the Foot. My doctor is a foot and ankle orthopedist at a sports clinic. At night I massage the incision very lightly using an ointment with comfrey and St. Johns Wort. IV sedation requires the assistance of an anesthesiologist to administer the medication and monitor your vital signs. The zero drop hasn't bugged me as I expected it might. To book an appointment at Metroplex Foot and Ankle LLP, call us at 214-217-3668. . With neurectomy, the healing process can take much longer. Thrombosis prophylaxis (e.g. Wow, you jumped right in shortly after your surgery ehh? Your email address will not be published. So if you are dealing with an odd sensation or pain underneath one of your toes, talk to a foot specialist to see if Morton's neuroma could be the cause, along with the best way to treat your individual case. So, you will always have one contact person who will be very familiar with your case and assigned to you throughout your stay at Gelenk-Klinik. Your orthopaedic surgeon will discuss your options with you. Massaging the foot during the first 3 months from surgery . It was painless and quickjust a quick snip of the suture holding it in and a fast pull of the drain tube from the incision. The doctor really outdid himself there. One treatment option is a Morton's Neuroma injection. Our goal is for you to experience as little pain as possible after surgery. On the eighth day I was able to stop dressing the stitches and drain incision with gauze because it finally healed up enough. He said I could walk in the boot right away, of course the first 2 days were slow and agonizing. That means taking a tactical break from regular running in favour of low-impact activities, like swimming. The Pros and Cons of Neuroma Surgery | Family Foot & Ankle. RE Musson, "Ultrasound guided alcohol ablation of Morton's neuroma," Foot & Ankle International, 33(3) (Mar 2012): 196-201. Traditionally, the incision has been done on the dorsal side, or top, of the foot, although it can be done using a plantar approach (through the bottom of the foot). Ill check out some of the footwear you mentioned. Protocols differ, and you should follow the specific instructions of your operating surgeon. I never think about it any more and don't have any neuroma pain like I used to. After surgery you will receive 24-hour care from experienced nursing staff and experienced physiotherapists. This can cause numbness, tingling, or pain similar to what you had before the surgery. Please be aware that this post may contain Affiliate Links to certain products. It worked but was annoying to have to stop frequently to take care of the issue. I guess recent studies show that if not fully healed, impact of the surgical area can cause injury and the stump. Day 1) i applied them for 2 hrs and i placed my feet on the ice pack (never directly to skin). Cortisone injectionsonly worked for a few weeks at at time. Symptoms of Morton's Neuroma usually consist of pain, tingling, numbness and burning sensations. Good luck! I was going to suggest Altras and then I read further ;-) These shoes have been a wonder for my neuroma, which isn't all that bad.Good luck with the healing and Hardrock training!Miss you guys! You will also be using a special shoe to offload the forefoot for 2 to 3 weeks. AAOS does not endorse any treatments, procedures, products, or physicians referenced herein. I had the surgery in December. ThanksShawn. Even after successful surgical treatment, it is possible for a Mortons neuroma to come back. The numbness typically wears off after 3-4 months. I live in dallas. We think the trapping is brought on by abnormal foot biomechanics and wearing the wrong footwear. Put Away Your Painful Shoes And Walk With Me! I live in dallas, tx. Feeling of having a "pebble in your shoe" or "walking on razor blades". About OrthoInfoEditorial Board Our ContributorsOur Subspecialty Partners Contact Us, Privacy PolicyTerms & Conditions Linking Policy AAOS Newsroom Find an FAAOS Surgeon. One week after surgery I was able to walk pretty normally in my wide, maximally cushioned Altra shoes but still used hiking poles for added stability on trails. Best Shoes for Morton's Neuroma AUTHOR: Lisa Kay. You only need to bring your personal medication, comfortable clothes and sleepwear. The neuroma was "quite sizable". There are 2 main treatment options for Morton's Neuroma: Conservative treatment and Non-conservative. when I perform neuroma surgery I try to make that the only procedure. It could be the result of an incorrect diagnosis, leading to a failed surgery, or it is a result of the neuroma stump formation. In some cases, a stump neuroma may form. Morton's neuroma is not actually a tumor, but a thickening of the tissue that surrounds the digital nerve leading to the toes. Here its important to determine the size of the Morton's neuroma by MRI. There may be some numbness in the toe. Now five days post-op I'm walking around pretty well but with a small "hitch in my giddy-up." Hey JasonThanks for the detailed accounting of your travails with the foot neuroma. This will again vary from person to person. You could try other conservative methods. The toes will remain puffy / swollen for about 3 months. I hope it can be helpful to anyone else going through this condition. Swelling is a normal symptom of the neuroma as well. This will depend on the surgeon you use, but there are more cases of successful procedures, 70% than the failed procedures (30%). This will depend on the type of surgery you have opted for. I hope your recovery goes great, coldsoil. Hey Shawn, glad you got it done and you're on you way to recovery. The procedure is done in about 8 minutes. These signs of inflammation are reversible to a certain extent if the mechanical pressure on the nerve is eliminated. This information is provided as an educational service and is not intended to serve as medical advice. Diagnosis and preparing for Morton's neuroma surgery. This involves massage, strengthening, and mobility exercise. Checking the position of the toes and foot for common deformities that may also cause pain in the forefoot. The metatarsal bones are located . fon: +49-761-79117-228 Morton's neuroma pain is a sign that the digital nerve is in distress. Right at two weeks post-op my right ankle started feeling super painful and was swollen a good bit. I went off pain meds day 3. The neuroma is dissected free of the nerve to which it is attached and excised. Morton's Neuroma Surgery; Post-surgical Pain and Stump Neuromas; Scientific Discussion of Morton's Neuroma (Morton's Metatarsalgia) I have a big rail race over labor day that I am hoping to be healed up in time to train for, so I am going to follow his instructions to a T. It's going to be crazy-making, though! Save my name, email, and website in this browser for the next time I comment. If conservative treatment does not relieve your symptoms, however, you may require a Mortons neuroma excision. The assigned anaesthetist will already start pain management during the procedure. Do you find you have any lingering scar tissue / stiffness in that area of your foot? In other words, it can take 3-4 months to become fully mobile. To access the nerve, the surgeon can make an incision on either the top or bottom of the foot over the web space. This topic is answered by a medical expert. Although this surgery gave her some relief, she continued to have pain in this area making it difficult to walk for extended periods. Got an MRI ordered and then it seems like surgery is iniveitable. If the size is less than 0.8 cm, surgery can be used to save the nerve (neurolysis). We typically perform Mortons neuroma surgery under general anaesthesia. if a person is too active after the surgery this space can . Premium orthotic insoles with anatomical arch support (removable) and Arch Booster re-align the foot and entire body posture. The foot specialists in Germany will first need current MRI images and x-rays of the respective foot to assess the size of the Morton's neuroma and possibly other foot conditions. This is the most common method that your surgeon will likely perform. Hooray! Quote Reply. Thomas SchneiderOrthopaedic Specialist at the Gelenk Klinik Orthopaedic Hospital. If the nerve (yellow) is irritated, burning or stabbing metatarsal pain occurs throughout the area it supplies. It causes acute shooting, burning or stabbing pain in the metatarsus (metatarsalgia) and in the toes. Eight days post-op I began walking without thinking about my foot and didn't feel the need to modify my stride to avoid rocking up on the ball of my foot. Nonetheless - glad you made ityou are definitively the "driven" type bro!Based on your feedback and some of the comments, I ordered a pair of Altras and am excited to give them a try! The pinching prevents the nerve from being adequately supplied with nutrients. My foot was in a velcro boot so I could hobble around quite well. Germany It was bad enough I couldn't walk stairs normally at all and had to limp around everywhere. Hi, I just had surgery and pray I can plan a ultra for next year. Private room in the Gelenk-Klinik in Gundelfingen, Germany. While Mortons Neuroma surgery may appear like the best way to get rid of the pain once and for all, you need to weigh your options very carefully. Symptoms include pain, burning, numbness and tingling between two of the toes of the foot. Thanks for your replies, Jason! The actual surgical strategy is therefore often only determined during the procedure after directly analysing and viewing the Morton's neuroma. If the size is less than 0.8 cm, surgery can be used to save the nerve (neurolysis). I'd suspect that too will heal up as the nerve heals. Thus far PolicyTerms & Conditions Linking Policy aaos Newsroom Find an FAAOS surgeon around quite well Platelet Rich Plasma.... 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