Morton Neuroma Surgery

Knowsstuff
Thu, 19 Jan 2023 14:59:06 +0000

So I can only talk on generalities and hypothetical situations since I am not treating you but… I treat most as an injury due to my sports medicine practice in Podiatry.

There is confusion of having a entrapped nerve like a neuroma vs pre cortical stress fracture on the bone in the same region. The story I used to tell the Residents was that I had 3 people in a row for a second opinion to have neuroma surgery by the same doctor (true story)… Their symptoms were similar to a neuroma but something was off since the bone hurt also. X-rays didn’t show anything. Diagnostic ultrasound /mri showed the precortical stress fracture on all 3. They were all scheduled to have a nerve removed that wasn’t the problem. With off weight bearing and some physical therapy or other treatment they all recovered in 3 weeks to 100%…this was over 25 years ago but what it taught me is to go very conservative and treat first to failure. Notice I didn’t mention steroid shots. I use them seldomly if ever. If I am injecting you I want a diagnostic ultrasound /mri first depending on what I am looking for. If you introduce steroid to a bone problem that is not obvious then you can weaken the bone.

So off weight bearing, some physical therapy, excersies to strengthen the area has been highly successful followed with orthotics once I can achieved a moderate /major decrease of pain. Ice and over the counter Volteran work great with off loading. If injecting I usually use amniotic growth factor since it seems to work much better then cortisone.

I also rarely use the neuroma pad in my orthotics. Some orthos and chiros do it routinely. Every patient is different and the approach should not be cookie cutter. Your needs are different then an elite athlete etc.