Diagnosed with Mortons Neuroma

Hi Anthony - sorry to hear you have a Morton's Neuroma.  I had one some years ago and even after surgery I still cannot walk barefoot on hard surfaces.  Like you, it feels like there is a huge swollen lump under my foot, but in fact it looks normal.

I don't think the Morton's Neuroma will go away on its own and surgery of some sort is the 'cure'.  I have often wondered whether de-nervation, rather than surgically cutting open one's foot and removing the neuroma, might be better.  I suggest you ask about this, though remember surgeons make their living by cutting, so a non-cutting method such as de-nervation is unlikely to be favoured by a surgeon.

I found a metatarsal pad to be a waste of time and very uncomfortable.  What I have found works best is to have 2 insoles in my wide shoes with a hole cut in the bottom one where the pain is, such that there is less pressure on that particular spot.

Good luck

David

Hi David, thank you for your reply and I am sorry to hear you have had problems too. I am currently  waiting for a follow up appointment with my specialist, she advised if the insoles and pads do not no work then the next stage will be a cortosone injection. I am very nervous about going down this route or the surgery route as I have heard there a many risks and the success rate is poor.  So I am hoping there is another way.  At this stage I would not say I am in unbearable pain or that it is any worse than previous epoisodes, but the condition is proving to become a big inconvenience as I enjoy driving and going out on day trips walking. The first epoisodes I had was years ago when I was doing a long commute to work every day. Each epoisode seems to last about 5 months then I will have no symptoms for over a year. But then the symptoms return and I have another episode. It is very strange how it comes and goes and I can't think what I may have done to make it come and go. I do wonder if driving is the main cause  as at the start of each epoisode I only seem to notice the symptoms when driving a car. Eventually it extends to standing on hard floors, walking in the house barefoot etc. the cold weather seems to make it feel worse, the toes just feel so sensitive to the cold or being touched which makes it very difficult for doctors and specialists to examine my foot. At the moment I am trying to lose a big of weight to see if this helps (I am overweight borderline obese) and eating more vegetables, fruit, cutting out sodas etc. whether this will help I don't know but worth a try. I am glad I found this forum because not many people I know understand the condition and it helps to reach out to people going through the same thing. 

As I understand it, the cortisone injections only give temporary relief and you will keep having to have more injections with increasing frequency as the cortisone has less effect.  Ask your specialist about de-nervation.  I think it can be done with an injection of a chemical in the exact spot above the neuroma and done with an ultrasound to help direct the needle into the exact spot.

Some people recover from the surgery very quickly but for me it took ages.  The surgery is simple on the one hand but complicated on the other because they go in from the top of your foot and have to move all the bones etc out of the way to get at the neuroma.    After surgery you will likely have no feeling on the sides of your toes between toes 3 and 4 (Big toe = 1).

David

Hi David, 

Thank you for the advice, I will ask my specialist about the de-nerving option. The current episode is at 5 months now. At this stage it's very difficult to say if there is any improvement although it doesn't feel like it's getting worse so i guess that's something. Maybe losing the weight will help, I will keep you updated on my progress.

I have managed to book an appointment with my foot specialist in 4 weeks time.  Recently when driving I have noticed that the pressure now seems to be between the second and third toe, not between the third and fourth toe like it was before. How strange. What does this mean? 

I've got neuromas in both feet and have been dealing with them for about the past 6 years. It is quite a common condition. I went the cortisone injection route on one of them, but as another poster has mentioned, it is not a cure. They work at first, but then the pain returns. Also, during the course of the injections I developed a condition called hammer toe, which is where the toe becomes misshapen, and which in itself is painful and which I had to have surgically corrected. I later learned that this is a side effect of the cortisone injections.

Believing the doctors assurances that the success rate for neuroma surgery was very high, I then went that route on one of my feet. After the surgery, it seemed to be getting better for about 2 months, then it became painful again. I then learned that I had a condition called "stump" or amputation neuroma, which is where the nerve tries to re-grow. It is more painful than the original condition. So I saw a different doc, and about 2 years later he tried another surgery, only to have the condition return. 

I know there are many success stories out there regarding neuroma surgery, and I hate to be the bearer of bad news, but I think the success rate is vastly overstated. Some studies I've read put it at about 50%. The problem is how success is defined, and the lack of studies of this type surgery in general. Also be aware, if you have surgery, you will get scar tissue, this in itself will cause that lumpy feeling in your foot. My advice, avoid surgery if at all possible.

I'm now seeing a podiatrist who specializes in a procedure called radio frequency ablation (RFA). It basically involves neutralizing the nerve via heat produced by radio frequency waves via a sound guided needle inserted at the site. There are a series of 3 treatments at 2 month intervals, and so far after 1 treatment I've had good results. There is no invasive surgery, and minimal pain afterwards. The problem is finding that doc who can do the procedure. I've tried alcohol injections (sclerosing), but they were ineffective. However, they were not sound guided, which I think would make the procedure more effective. Sclerosing may also be covered under insurance, whereas RFA may not be.

Hope this helps and the best of luck in your treatment.

As far as footwear, I had custom orthotics made and wear them at all times. I also wear the metatarsal pads, which are built into the orthotic. I came across a shoe made by Hoka that has a very cushy sole, and after going through numerous other shoe brands I wear them exclusively. Getting a pair with a roomy, boxy toe is very important. 

Just thought I post an update. Over the last few weeks I am pleased to say I have made incredible progress with my feet. There is still some discomfort and I still have problems walking barefoot on hard surfaces, but overall my feet feel so much better and daily activities are a lot more comfortable.  Wearing insoles and the metatarsal pad my podiatrist provided seems to have really helped. I have also lost a lot of weight in the last month, which my podiatrist seems to think would Definately have helped as well. Not sure if this will help everyone but just a little advise for people suffering. - I never ever wear shoes without insoles anymore and at the first sign they need replacing I so so straight away. This has Definately helped me and I can feel a massive difference. I never wear shoes that are even the slightest bit tight and I always make sure I have enough room to move my toes. I think this is also important and one of the other things that has helped 😃

Anthony - glad to hear you're getting some relief from the neuroma. 

One thing. You mentioned insoles, but I'm not sure if they are customized for your foot. I think thats one important thing to have done, although they are pricey. But insurance should pick up the cost. 

The neuroma may go away by itself without further treatment. You never know. Like Broquerie has mentioned, surgeons like to cut and your doc may want to push you in that direction, but I would avoid that if at all possible. I think if you end up having to get it done, find someone who will go through the top rather than the bottom. It leaves less scare tissue on the bottom, which in itself will leave you with a permanent lumpy feel when you walk. There's also quicker recovery time. Also, as I've mentioned, try to find a doc who will do de-nervation such as radio frequency ablation. Its non-surgical, therefore much less risk.

Good luck!