Basic Information You Need To Know About Neuroma
Its normal for people to experience pain in the feet once in a while. However, foot neuroma isnt just any kind of foot problem. It doesnt go away on its own and it can get worse through time. This is why its important to be informed about foot neuroma. Here are some things you need to know about foot neuroma.
What Does Mortons Neuroma Surgery Involve
Surgery is normally a day case procedure, performed under a general anaesthetic, with a post-operative local anaesthetic administered in the foot to minimise pain. A miniscule incision is made between the toes, either to make more space around the nerve by taking away the neighbouring tissue or to remove a portion of the nerve itself, which will result in the area between your toes becoming permanently numb.
Attending a pre-assessment screening is good way of maximising the benefits of your surgery. At your screening, youll have your blood tested to assess your Vitamin D levels swabs will be taken to check for infection or other issues youll be weighed and have a chance to talk through your medical history, to highlight any potential anaesthetics issues.
It is highly recommended that you stop smoking at least eight weeks before surgery because smoking affects your ability to heal and leads to health issues, such as greater risk of pulmonary embolism or deep vein thrombosis .
Who Qualifies For Morton’s Neuroma Surgery
In order to fully assess Morton’s neuroma, we need current MRI images. These images are then used to decide together with you if surgery is necessary and what type of surgery is best in your specific case.
In the early stages, Morton’s neuroma can often be treated conservatively, using insoles and performing foot exercises. If the personal quality of life has been reduced and pain is severe, and if conservative treatment is unsuccessful, surgery is an option. If the size is less than 0.8 cm, surgery can be used to save the nerve . If Morton’s neuroma swelling is too severe, the nerve will need to be removed .
The Early Signs Of Neuroma
Sometimes Mortons neuroma wont have obvious signs like a lump. Instead, youll feel varying degrees of pain in your sole or toes. However, how does one differentiate Mortons neuroma from other foot conditions? Here are the common symptoms of foot neuroma:
- Feeling like theres a pebble under the ball of your feet
- Tingling and numbness in your toes
- Sharp or burning pain from the ball of the foot to your toes
- Pain while standing or walking
If you have any of the symptoms of foot neuroma, its advisable to see a medical professional immediately. This way, you can confirm if the pain is caused by foot neuroma or another condition.
How Is A Neuroma Treated
Mortons neuroma treatment should always involve a conservative approach initially. Many neuromas under a certain size respond well to conservative treatment including orthotic therapy with neuroma pads, foot mobilisation and sometimes accupuncture. If a neuroma is very large, surgery may be the only solution.
Your Podiatrist will attempt to remove the causative factors. A treatment program will be designed which will generally involve the steps listed below. These include:
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When Should You See A Doctor
If you have foot pain that doesnt go away even after changing your footwear or stopping activities that might be responsible, see your doctor. Mortons neuroma is treatable, but if its not treated promptly it can lead to permanent nerve damage.
Your doctor will ask you how the pain started and physically examine your foot. Theyll put pressure on the ball of your foot and move your toes to see where you have pain. A doctor will usually be able to diagnose Mortons neuroma just from a physical examination and by discussing your symptoms.
To rule out other possible causes of your pain, such as arthritis or a stress fracture, your doctor may sometimes order imaging tests. These can include:
- X-rays to rule out arthritis or fractures
- ultrasound images to identify abnormalities in soft tissue
- an MRI to identify soft tissue abnormalities
If your doctor suspects another nerve condition, they may also perform an electromyography. This test measures the electrical activity produced by your muscles, which can help your doctor better understand how well your nerves are functioning.
Treatment depends on the severity of your symptoms. Your doctor will usually use a graduated plan. That means youll start with conservative treatment and move on to more aggressive treatments if your pain persists.
Will A Mortons Neuroma Go Away
Once it has formed, a Mortons neuroma will not go away. However, the pain can improve, or even disappear. The earlier you receive treatment, the better your chance of having the pain resolve.
With more advanced neuromas, the pain may return in episodes as you spend a lot a time on your feet, or continue wearing tight shoes. This may require repeat treatments. A neuroma can be removed entirely, through surgery. However, there is a 20-30% chance of it re-growing .
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Advanced Injection Techniques Treatment
If pain continues despite several months of conservative treatment, your pain doctor may recommend advanced injection techniques. They are conducted in an outpatient setting, with local anesthesia , and ultrasound guidance.
Sclerosing alcohol injections diluted alcohol is injected in the neuroma in order to destroy it. Treatment is repeated 24 times.
- Success rate equal to or exceeding that for surgical neurectomy, with fewer risks. However, approximately 20% of cases may progress to surgery.
- Short-term pain after the procedure is common.
Radio Frequency Ablation heat generated from medium frequency alternating current is used to ablate the neuroma.
- Equally or more reliable than alcohol injections.
- An effective treatment after conservative treatment fails and prior to surgical intervention.
Cryogenic neuroablation involves a small incision in the foot and insertion of a cooled needle in order to freeze the neuroma.
- Less painful than alcohol injections.
- Can be used instead of neurectomy .
- Unlike neurectomy, it does not have a risk of neuroma regrowth.
Symptoms Of Mortons Neuroma
If youve ever had the feeling of walking around with a rock in your shoe, then might understand the first symptoms of Mortons neuroma. Often, this condition causes you to feel as if a rock is stuck in your shoe, or something is poking you in the ball of the foot Dr. Janet Pearl, M.D.
- Wearing closed shoes feels uncomfortable .
- Pebble-in-shoe or bunched-up sock kind of feeling
- Sharp burning to almost disabling pain
- Constant unexplained toe cramps, especially after physical activity
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Where Does Mortons Neuroma Happen
Usually, the neuroma happens between the bones of your third and fourth toes. Those are the two toes closest to the pinky toe . But Mortons neuroma can form between the second and third toes as well.
You develop the condition when the nerve suffers excessive pressure or compression between the toes. That compression causes inflammation and irritation.
Should I Expect Pain After Morton’s Neuroma Surgery
Every procedure causes pain. We always strive to keep pain after Mortons neuroma surgery as low as possible. The assigned anaesthetist will already start pain management during the procedure. In many cases the anaesthetist uses a so-called nerve block during surgery, which keeps the respective foot pain free for approx. 30 hours. This already manages the greatest wave of pain, which can then be easily treated with regular medication. Our goal is for you to experience as little pain as possible after surgery.
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Minimally Invasive Surgery For Morton’s Neuroma To Save The Nerve
Nerve compression is caused by mechanical pressure on the plantar nerve of the foot. The irritation of the nerve causes the connective tissue surrounding the foot nerve to swell, scar tissue develops and fluid build.
The swelling causes ischaemia . The pinching prevents the nerve from being adequately supplied with nutrients. This causes the typical symptoms such as numbness, shooting pain, and tingling. These signs of inflammation are reversible to a certain extent if the mechanical pressure on the nerve is eliminated.
For many nerve compression syndromes , decompressing the nerve is therefore an appropriate treatment strategy.If the Morton’s neuroma is not yet too severe , it can be operated on just like any other nerve compression syndrome to save the nerve.
We have been seeing excellent medical results for years by relieving the nerve and possibly decompression by repositioning the metatarsal bones. We have particularly seen good results with respect to preventing recurrence . Recurrences are considerably more likely after amputating the nerve , as this does not remedy the underlying deformity of the arch. Yet neurectomy so actually amputating the nerve is still considered the standard treatment for Mortons neuralgia. All to often the nerve is simply removed to treat Morton neuralgia without evaluating the procedure to save the nerve.
Benefits of surgery to save the nerve
Can Mortons Neuroma Be Prevented
You can take steps to prevent Mortons neuroma:
- Dont wear tight or high-heeled shoes for long periods.
- Wear shoes with a wide toe box, so your toes arent cramped.
- When youre more active, wear athletic shoes with plenty of padding to cushion the balls of your feet.
- Maintain a healthy weight, since extra pounds put more pressure on your foot.
- For athletes, talk to your coach or trainer to discuss tweaking activities for less pressure on the foot.
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Is Mortons Neuroma A Tumor
The neuroma in Mortons neuroma is slightly misleading. Neuromas are noncancerous tumors found on nerves throughout the body. They involve a growth of extra nerve tissue.
With Mortons neuroma, theres no growth and no tumor. Instead, the existing tissue around the nerve becomes inflamed and gets bigger.
Aftercare Rehabilitation Following Morton’s Neuroma Surgery
The inpatient stay after surgery for Morton’s neuroma is typically 2 days. After neurolysis you should wear a special shoe to offload the forefoot for 2 to 3 weeks. The foot can bear full weight again about 3 to 6 weeks after neurolysis.
After neurectomy you will be using the forefoot offloading shoe for about 3 weeks. After that you may wear a normal shoe with a flat sole, which supports the transverse arch and leaves enough room for the toes. In the first 2 months after the operation you should avoid heavier strain and rolling of the foot.
Whilst unable to bear the full weight you will have forearm crutches. Thrombosis prophylaxis is therefore vital. You should also wear compression stockings until full weight bearing has been restored. We will ensure you receive the aids required after surgery.
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How Is Morton’s Neuroma Surgery Performed At Gelenk
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. There are generallytwo methods which can be used: neurolysis to save the nerve or removing the nerve. Both procedures take about 30 minutes.
Mortons Neuroma Symptoms And Treatment
Mortons neuroma is an overgrowth of nerve tissue that causes pain in the ball of the foot. If you have a Mortons neuroma you may feel as if there is a pebble in your shoe. Eventually you may suffer a sharp, burning pain in the foot and numbness between the toes.
Repetitive foot overload, from wearing tight shoes or from high impact sports, is a common cause for Mortons neuroma. Simple measures like switching to comfortable shoes, stopping high impact exercise, and wearing orthotic supports, may relieve the pain.
For long-lasting neuroma pain, a visit to a pain management doctor can help. Corticosteroid injections and advanced techniques like nerve ablation and cryotherapy may treat your pain, without surgery.
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Can I Treat Mortons Neuroma At Home
These steps may improve your symptoms:
- Wear good shoes: Choose supportive shoes with a wide toe box. Shoes with shock-absorbent soles and proper insoles can help. Dont close the top of the shoe too tightly. And avoid shoes that are tight, have pointed-toes or have heels more than 2 inches high.
- Use shoe pads: Put these over-the-counter pads into your shoe to relieve pressure.
- Use an ice pack: Place an ice pack on your toes to reduce pain and swelling.
- Rest: Try to rest and massage your feet. Avoid sports and other activities that put a lot of pressure on your foot.
What Can You Expect
Your recovery time will depend on the severity of your Mortons neuroma and the type of treatment you receive. For some people, a change to wider shoes or shoe inserts gives quick relief. Others may require injections and painkillers to get relief over time.
Surgical recovery time varies. The recovery from nerve decompression surgery is quick. You will be able to bear weight on the foot and use a padded shoe right after surgery.
Recovery is longer for a neurectomy, ranging from 1 to 6 weeks, depending on where the surgical cut is made. If the incision is at the bottom of your foot, you may need to be on crutches for three weeks and have a longer recovery time. If the incision is on the top of the foot, you can put weight on your foot right away while wearing a special boot.
In both cases, youll have to limit your activities and sit with your foot elevated above your heart level as often as you can. Youll also have to keep the foot dry until the incision heals. Your doctor will change the surgical dressing in 10 to 14 days. How soon afterward you can go back to work will depend on how much your job requires you to be on your feet.
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Our Treatments And Procedures
There are a wide range of treatments and procedures which can be used to treat Mortons Neuroma. However, each individual responds differently to certain kinds of treatment. That is why at The Center For Mortons Neuroma, we carefully make our diagnosis before deciding on the best approach to treat your Mortons Neuroma. Here are some of them:
Seek Medical Help For Neuroma
If you need medical help with foot neuroma, The Center For Mortons Neuroma is here for you. We specialize in Mortons neuroma. Our goal is to provide specialized care and access to treatment for people with Mortons neuroma. We help patients find a non-invasive treatment thatll help them recuperate quickly.
Put an end to the pain caused by foot neuroma. Book a consultation with The Center For Mortons Neuroma today.
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Podiatrists In South Texas
If you are experiencing intermittent or constant foot pain, see an experienced podiatrist for a proper diagnosis and treatment. The doctors here at The Podiatry Group of South Texas know how to pinpoint the cause of your pain and provide a solution that works for you.
If you have any questions or would like to schedule an appointment, contact us today by calling us at our location nearest you, or fill out our appointment request form online now. We look forward to giving you the foot care that you deserve!
Orthopaedic Surgeon And Foot And Ankle Specialist For Morton’s Neuroma At Gelenk
Here at Gelenk-Klinik, a close relationship between the physician and their patient is important. This means: You will be in the care of your treating physician from the initial examination until after surgery. 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. Our experts in foot and ankle surgery are the experienced specialists Dr. Thomas Schneider and Dr. Martin Rinio. Theyre certified foot and ankle surgeons whose continuing education, diagnostics and surgical quality is reviewed annually by an independent German professional society . The orthopaedic Gelenk-Klinik is therefore a speciality centre with the title “Centre for foot and ankle surgery” .
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Treatment From A Foot Specialist
Treatments from a foot specialist, such as a podiatrist or foot and ankle surgeon, may include:
- specially made soft pads or insoles to take pressure off the painful area of your foot
- non-surgical treatments such as using heat to treat the nerve
- steroid or alcohol injections, or foot surgery if you have very severe symptoms or other treatments are not working
Referral to a podiatrist on the NHS may not be available to everyone and waiting times can be long.
You can pay to see a podiatrist privately.
Treatments For Mortons Neuroma
Although many of us like to wear high heels because they make us taller, high heels tend to put pressure particularly at the ball of your foot. This can lead to a painful nerve condition called Mortons neuroma.
In addition to wearing high heels, Mortons neuroma can be caused by having flatfoot, high arches, bunions, hammertoes, or playing sports that put repeated pressure on the feet. This condition is often felt between the third and fourth toes of your feet , giving you a feeling akin to standing on a pebble in your footwear. It can also cause tingling and numbness in your toe.
Fortunately, there are several treatment options available for those experiencing this condition. Lets talk about some of the easy ways to relieve pain caused by Mortons neuroma and who can help you find relief if the pain persists.
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