[julpat]

I had a stress fracture on my third toe nearly 9 years ago. After that time, I have had to use crutches to move around for about 24 - 48 hours on average 3 to 5 times a year. I recently went to the doctor to find out why I kept having this pain, especially after this last time I used the crutches for 3-4 days and it didn't get any better. The diagnosis is of course Morton's Neuroma and the doctor thinks that has been my problem all of these years. They have offered me cortisone and alcohol injections. I do well with needles most of the time but I have super sensitive feet and am near "nervous breakdown" afraid of a needle in my foot. I lead a fairly active life. I like to exercise and walk. I coach basketball and soccer and play volleyball at my church. I am also the mother of three children (two that are 4 and 7). I am tired of being in pain everyday from just regular activities like running to the grocery store. I have been wearing a boot for 4 weeks, had a medrol pack, and taking anti-inflammatories for treatment so far.

I am considering surgery? I don't like a lot of the info I have read on injections.What are your thoughts on the treatment options?

[diam-inc]

Hi Julpat - I, too, have put up with MN for 18 months. I've tried about everything including the steroid injections that didn't work. I have now had my first alcohol injection and am hoping to get some much needed relief from them. I'm optimistic. I'm not sure why you are afraid of the injections. They are totally painless. I mean absolutely painless. The Doc puts lidacain(?) in with the injections and there is no feeling at all. Of course he injects through the top of the foot while guiding the inserted needle with ulrasound from the bottom. With everything that I have read (and the Doc confirms) the alcohol injections are 94% successful and even for the few that they don't work on then surgery is still an option. The reverse is not the case. Of course, you will end up with some numbness between your two toes involved but it's a small price to pay considering the options. The surgery will leave the same numbness. I learned long ago not to pay a lot of attention to the negative comments on this and other sites. Should the alcohol injections not work for me then the surgery is next and I will definitely have it done. I'm sick of this. Talk to your podiatrist about the alcohol injections before doing surgery. Good luck! - Lonnie

[BEAN123]

Hi,

I'm hoping my input will help in some way. FIrst, please don't think of this response as negative as I realize some have been very much helped by the surgery. Yet, I really think I can offer you things to think about and discuss with your doctor. In 1992 I had a lot of cramping in my feet. The diagnosis was Morton's neuroma in more than one interspace, but especially between my 2nd and 3rd toe. They did surgery on all 4 over a period of 2 years. Anyways...for the first 4 years I was doing excellent - all the cramping was gone. It was fantastic. However, over time, scar tissue grew in and a new neuromas also formed. I also had small nerve fibers grow too because when a nerve is cut this can happen and even new neuromas can form. The small nerve fibers were as debilitating as the regular neuroma. (My neuromas always caused intense cramping and also a weak feeling in my foot as well as the usual stabbing/electrical etc feeling - the cramping was the worst). Anyways...when they did my first 2nd surgery they almost could not do the surgery as they said the scar tissue was terrible - they said it was like someone dumped superglue into my foot. The surgeon didn't want to cut out the scar tissue because he said it would later regrow even more, so he pushed it aside away from the interspace - I can still feel it bunched up in there. They did not find another neuroma as I thought - it was all the scar tissue. However, they did find a new neuroma developed on the other foot and it's towards the middle of the foot and can only be approached from the bottom and they said it's risky to operate again because I have zero fat pad - literally. Often they can do the 2nd surgeries from the top again but the scar tissue will make it all worse ultimately - so sometimes they go from the bottom but then you have to be on crutches 6 weeks or so and that can cause scar tissue under the foot! The surgeon also told me they don't like to use cortisone too much anymore - perhaps a shot - but not much more as they found that cortisone causes much of the excessive scar tissue in people - I guess that's like my case & I never had more than the allowable amount of shots. My having had multiple neuromas may make me very bad - if you just have one I suppose surgery is worth considering. However, several foot doctors and even orthopedics that I have seen over the last few years told me they don't do the surgeries as much anymore because they can see how the surgery can cause so many problems down the road. I would suggest asking your doctor first about: physical therapy (also is it really the neuroma or other areas of the foot that are tight from your fracture - (I found that when they worked on the tissues around the neuroma it helped years ago before I had surgery,) massage therapy, is your back ok - that can affect the feet, shoes - don't wear a shoe without an arch I was told nor too tight, padding, strapping and especially foot orthotics -they can really help. Also, be sure it's not really metatarsalgia that you have (I hope I spelled that right). If you have very little fat pad approach surgery very cautiously. I can no longer drive - it's hard to take a shower - I can't walk more than 1/16 mile - I can't wear socks at all with my shoes on (only w/o shoes) - sometimes I cannot wear my shoes and then just wear socks even in the winter outside. On the positive side, like I said if you just have one neuroma, perhaps it's worth considering surgery if you feel very disabled by the neruoma. Yet, if it's mostly a pain you can withstand, if it were me, I would not do the surgery knowing what I know now. Even doctors told me many patients later say the surgery caused problems worse than the original - years down the road. So really think about how disabling it is. The surgery itself - from the top of the foot - is easy and an easy "recovery" initially. It does leave sort of a numbness in the toes which isn't too bad but in my case it did ruin some of the small circulation - small blood vessels. But really really think about the risks, pluses and minuses, and how disabled you are currently by it now. I wish you luck and the best.