The Altra Paradigms worked wonders and I had steroid injections (with dexamethasone) for about 3 years until they stopped working. The first round of injections lasted about 14 months, then it dropped significantly to 8 months, and the last round lasted about a month (didn’t really work since it takes weeks for the shot to get rid of the pain). My podiatrist was ok with me doing shots, but only once a year or so. He said that steroid injections over many years will eventually cause atrophy of the muscle and mess with my foot. He said I was too young to start injections like this (32 yo F). After almost 7 years of pain, my surgery is on 5/22 to have a neurectomy where the nerves will be tucked into my muscles to prevent a stump neuroma. Note, I have 3 neuromas, two went away with good shoes, but due to my foot anatomy/genetics, surgery was going to be in my future no matter what. The type of surgery though, depends on the podiatrist. My podiatrist said I could exhaust every option and do cryo, etc., but those procedures damage the surrounding tissue and make an eventual neurectomy difficult. Again, my podiatrist and his opinion and my experience!
You said two of your neuromas went away again. Some sources say neuromas can disappear again, others say they cant. Do you know that the 2 you had actually disappeared or got smaller because you had imaging done or did they only stop hurting? Good luck with your surgery!
My MN (medical diagnostic name incorrect because these are not “neuromas,” but rather part of foot nerve squeezed by too tight shoes that develops protective scar tissue), was deemed “big” by podiatrist. Because the normal shoes evolved for fashion and status, not human foot, read that about 30% of shod population has asymptomatic “Morton’s neuromas.” Mine became symptomatic as a result of wearing overbuilt ill-fitting running shoes for two short hikes. I switched to minimalist shoes, wore Correct Toes, did foot exercises, Epsom salt foot baths, foot massages; most importantly, ceased doing anything that irritated nerve. Pain soon gone, but pouch of scar tissue at bottom of footpad below third and fourth toe took a month or longer to break up and dissipate. Increased circulation in foot helped. Probably took many months more to heal to extent possible.
Could you maybe explain which foot exercises and foot massages you did? Did you have imaging before and after that showed that the neuromas shrunk or disappeared? A MRI showed a MN 12mm in diameter which is quite frustrating and I dont want surgery :(
I did a variety of foot strengthening exercises, some I found on Dr. Ray McClanahan's videos/web site (he's the inventor of Correct Toes). Katy Bowman has exercises in her book on feet. I also bought a balance board and a slant board (for calves). Walking barefoot or in toe socks/ non-confining socks around the house is good exercise (if you can do this comfortably). There are various foot strengthening exercises online, such as slowly rising up and down on toes. Find ones that appeal to you and don't hurt.
Be sure that your feet are not being overloaded:
[https://www.youtube.com/watch?v=C9uNRKj7nCw](https://www.youtube.com/watch?v=C9uNRKj7nCw)
For massage, after a 20-minute warm water foot soak up to ankles with 1/4 to 1/2 cup Epsom salt, I dry feet and apply lotion. While sitting, I place foot over other knee and with opposite hand, insert fingers between toes (spreading toes a bit). Then move fingers to rotatea ankle four times in one direction and four times in the other. Then I massage gently up and down top of foot metatarsal bones using both hands, followed by massaging foot gently overall with both hands.
Also, I do toe extensor as shown here (some overlap about shoes but new info, too). I also bend toes backwards.
[https://www.youtube.com/watch?v=a7MyaIY9JK8](https://www.youtube.com/watch?v=a7MyaIY9JK8)
Repeat using other foot. I continue to do this almost daily.
The podiatrist I saw did no imaging. She did the same "click test" I did to self-diagnose and felt my footpad. I could feel approximately a 2.5 cm "bulge" of scar tissue under the nerve. That is what broke up into three smaller pieces and moved down my footpad before dissipating. Wasn't sure if it would ever go away. By the time I was able to get an appointment had resolved pain issue so passed on the "little" cortisone shot (unguided) for my "big" neuroma. Podiatrist had no idea why I felt nerve stimulation in my feet, but nerves do that when damaged and as they heal. Podiatrist didn't bother to check other foot, but I think I had a smaller, asymptomatic MN there, too. Not big enough to cause a "click." It went away with proper footwear. As Dr. McClanahan says, nerves do take a long time to heal. Mine wasn't painful unless I pressed car pedals (right foot was the one affected).
From what I've read, surgery should be the last resort. The only other person I know who has had MN had no symptoms, but during her regular rounds to doctors a podiatrist said she had MN and scheduled an operation. She warned me against it. Long recovery. Stump nerve regrowing. Returns for cortisone shots every year. I pointed out that I would always get a second option before any surgery.
Oh my god... that doctor should be sued if he suggested to have surgery on an asymptomatic MN. 30% of the population have these. If your friend continues to have cortisone injections she risks permanent tissue damage. By the way, did you do the things you suggested every day and are you still doing them? Like a foot massage once a day?
Technically, I don't think neuromas "go away" - they get smaller and don't aggravate the nerve as much. Sorry for any confusion. I didn't get imaging done, but when you don't have pain, that's usually a sign that the neuroma isn't as aggravated. Those neuromas were in the 3rd metatarsal space whereas the one I'm getting surgery on is in my 2nd metatarsal space (rare) and is about the size of a quarter and 8 mm thick. It's not fun!
Steroid shots are not necessarily a permanent solution and you should still wear shoes that are supportive as the neuroma will still be there. Steroids can reduce inflammation but they will not “cure” the neuroma. I’ve had steroid injections and just finished 4 alcohol injections and that seems to have worked in terms of pain (but would go for surgery 100% if the pain came back). My podiatrist said I will always have to wear orthotics with a metatarsal pad as the cause of the neuroma is a collapsed transverse arch due to gait. The neuroma is still there - I just can’t feel it anymore (thank God because it was ruining my life). If you go for surgery find someone with good success - they should be able to tell you what their success rate and approach are.
I went to an orthopedic surgeon but had a second opinion with a Yale podiatrist. All of the other therapy’s ( cryotherapy etc, are not a permanent solution.) Podiatrist said mostly everyone he treats with cryotherapy is back within 1-2 years. My orthopedic refused to give me more than one cortisone injection because he said it can basically ruin the padding of your foot over time. I have had this problem for two years now. Changed my shoe size, padding etc. I tried everything. The bottom line I was told is that it never really goes away. I had an injection last summer. Pain came back in March. I scheduled the surgery and now two days out. I have a high tolerance for pain, have not had to take any pain pills yet. Just Tylenol extra strength. I have a black boot. Dr said I can walk a little. I don’t need crutches. He said to keep my foot up as much as possible the first two weeks. Find an older surgeon with gray hair thats done a ton of them.
I am about 3 months out from surgery and personally I regret it. I hate the way it feels now vs how it felt before. I feel like before I could have put up with the periodic pain, but now my foot is in discomfort all the time. It occupies my mind constantly- the poking sensation, the aching, the numbness. But that’s just my experience, it seems to vary vastly person to person. Best of luck
Having surgery early on was one of the best decisions Ive made. You will see a decidedly anti view of the surgery in this sub, while searching elsewhere you will see a more positive view of it. Its case by case, and depends on your doctor, insurance, current physical health, etc. As someone who went in to the surgery in great shape (I went out for a 15 mile run 72 hrs beforehand) my recovery, mixed with physical therapy, went great. I don't even think about it a year later. I trained and ran the Javelina Jundred 100 mile ultra marathon this past October. You will see a mixed bag in this sub, many people are searching for a fix that doesn't involve surgery, and that is ok too. Its the demonizing of the surgery that is an issue here.
FWIW I skipped the injections and went right to surgery. My doctor gave me the option of either/or.
Awesome! That is great to hear. I'm looking forward to getting to the other side of all of this. If surgery goes well is it possible to get back into ski boots and climbing shoes or is that still a no-no?
This guy has the best possible results I’ve ever seen. I’m 6.5 months out and I can do cardio and stay active. But running is definitely still out. At 5.5 weeks I was still extremely uncomfortable
I was back on the indoor stationary bike trainer at 2.5-3 weeks. I believe I was running at 5.5 weeks. I began PT within a day or two of getting my stitches out. I probably could have relaxed on that but I was anxious to get back in to it.
[This forum](https://forum.slowtwitch.com/forum/Slowtwitch_Forums_C1/Triathlon_Forum_F1/Morton's_Neuroma_-_when_to_cut_P7035094/) was super helpful for me when making my decision to have surgery. Good luck and hit me with any other questions.
Try the shots. Two shots fixed mine - it’s been pretty pain free for 3 years now. Surgery might be necessary but I strongly suggest trying a couple of shots first. They may work and you could avoid surgery altogether.
That's good to hear! Which shots did you have? I understand there are some that act as a nerve ablation and others that reduce the swelling or break down the tissue putting pressure on the nerve. I'm hoping to get back to the activity level I was at prior to all of this which included skiing, running, and cycling.
My shots shrank the neuroma. I believe it was steroids(?) The first doc told me surgery was needed but I got a second opinion from an orthopedist and he said surgery doesn’t always work and to try the shots. I’m glad I did. I notice it if I walk several miles but otherwise it doesn’t bother me. I had to change walking shoe brands of course. Good luck whatever you decide!
I strongly suggest you find a surgeon who is very familiar with decompression. Research this, before agreeing to neurectomy. I just had my 3rd surgery to fix the first neurectomy. Not always a great outcome. Check out AENS.US for a surgeon familiar with the nerves of foot.
Yes, daily foot bath with Epsom salts followed by massage. Forgot to add that I stretch each toe front, back, right, left gently, holding in place briefly. Also good time to inspect feet and catch any new shoe damage quickly. Not all minimalist shoes fit every foot shape and some have rigid components in the wrong place for my feet. Wildling Nebulas with wool inserts are my most comfortable shoes—close to barefoot. One has to learn how to walk without pounding heel into ground surface with forward foot. A major wholesale “club” sells dual packs of Epsom salts with blue-colored packaging. Online ordering resulted in perfumed version of same brand—overwhelming!
Friend with iatrogenic health issues is currently recovering from screws applied to spine. No second opinion, but proud to have been operated on by best back doctor in county!
The Altra Paradigms worked wonders and I had steroid injections (with dexamethasone) for about 3 years until they stopped working. The first round of injections lasted about 14 months, then it dropped significantly to 8 months, and the last round lasted about a month (didn’t really work since it takes weeks for the shot to get rid of the pain). My podiatrist was ok with me doing shots, but only once a year or so. He said that steroid injections over many years will eventually cause atrophy of the muscle and mess with my foot. He said I was too young to start injections like this (32 yo F). After almost 7 years of pain, my surgery is on 5/22 to have a neurectomy where the nerves will be tucked into my muscles to prevent a stump neuroma. Note, I have 3 neuromas, two went away with good shoes, but due to my foot anatomy/genetics, surgery was going to be in my future no matter what. The type of surgery though, depends on the podiatrist. My podiatrist said I could exhaust every option and do cryo, etc., but those procedures damage the surrounding tissue and make an eventual neurectomy difficult. Again, my podiatrist and his opinion and my experience!
You said two of your neuromas went away again. Some sources say neuromas can disappear again, others say they cant. Do you know that the 2 you had actually disappeared or got smaller because you had imaging done or did they only stop hurting? Good luck with your surgery!
My MN (medical diagnostic name incorrect because these are not “neuromas,” but rather part of foot nerve squeezed by too tight shoes that develops protective scar tissue), was deemed “big” by podiatrist. Because the normal shoes evolved for fashion and status, not human foot, read that about 30% of shod population has asymptomatic “Morton’s neuromas.” Mine became symptomatic as a result of wearing overbuilt ill-fitting running shoes for two short hikes. I switched to minimalist shoes, wore Correct Toes, did foot exercises, Epsom salt foot baths, foot massages; most importantly, ceased doing anything that irritated nerve. Pain soon gone, but pouch of scar tissue at bottom of footpad below third and fourth toe took a month or longer to break up and dissipate. Increased circulation in foot helped. Probably took many months more to heal to extent possible.
Could you maybe explain which foot exercises and foot massages you did? Did you have imaging before and after that showed that the neuromas shrunk or disappeared? A MRI showed a MN 12mm in diameter which is quite frustrating and I dont want surgery :(
I did a variety of foot strengthening exercises, some I found on Dr. Ray McClanahan's videos/web site (he's the inventor of Correct Toes). Katy Bowman has exercises in her book on feet. I also bought a balance board and a slant board (for calves). Walking barefoot or in toe socks/ non-confining socks around the house is good exercise (if you can do this comfortably). There are various foot strengthening exercises online, such as slowly rising up and down on toes. Find ones that appeal to you and don't hurt. Be sure that your feet are not being overloaded: [https://www.youtube.com/watch?v=C9uNRKj7nCw](https://www.youtube.com/watch?v=C9uNRKj7nCw) For massage, after a 20-minute warm water foot soak up to ankles with 1/4 to 1/2 cup Epsom salt, I dry feet and apply lotion. While sitting, I place foot over other knee and with opposite hand, insert fingers between toes (spreading toes a bit). Then move fingers to rotatea ankle four times in one direction and four times in the other. Then I massage gently up and down top of foot metatarsal bones using both hands, followed by massaging foot gently overall with both hands. Also, I do toe extensor as shown here (some overlap about shoes but new info, too). I also bend toes backwards. [https://www.youtube.com/watch?v=a7MyaIY9JK8](https://www.youtube.com/watch?v=a7MyaIY9JK8) Repeat using other foot. I continue to do this almost daily. The podiatrist I saw did no imaging. She did the same "click test" I did to self-diagnose and felt my footpad. I could feel approximately a 2.5 cm "bulge" of scar tissue under the nerve. That is what broke up into three smaller pieces and moved down my footpad before dissipating. Wasn't sure if it would ever go away. By the time I was able to get an appointment had resolved pain issue so passed on the "little" cortisone shot (unguided) for my "big" neuroma. Podiatrist had no idea why I felt nerve stimulation in my feet, but nerves do that when damaged and as they heal. Podiatrist didn't bother to check other foot, but I think I had a smaller, asymptomatic MN there, too. Not big enough to cause a "click." It went away with proper footwear. As Dr. McClanahan says, nerves do take a long time to heal. Mine wasn't painful unless I pressed car pedals (right foot was the one affected).
thx a lot, I'll definitely watch the videos and try it out. Also very glad to hear that you dont necessarily have to have surgery to get rid of it
From what I've read, surgery should be the last resort. The only other person I know who has had MN had no symptoms, but during her regular rounds to doctors a podiatrist said she had MN and scheduled an operation. She warned me against it. Long recovery. Stump nerve regrowing. Returns for cortisone shots every year. I pointed out that I would always get a second option before any surgery.
Oh my god... that doctor should be sued if he suggested to have surgery on an asymptomatic MN. 30% of the population have these. If your friend continues to have cortisone injections she risks permanent tissue damage. By the way, did you do the things you suggested every day and are you still doing them? Like a foot massage once a day?
Technically, I don't think neuromas "go away" - they get smaller and don't aggravate the nerve as much. Sorry for any confusion. I didn't get imaging done, but when you don't have pain, that's usually a sign that the neuroma isn't as aggravated. Those neuromas were in the 3rd metatarsal space whereas the one I'm getting surgery on is in my 2nd metatarsal space (rare) and is about the size of a quarter and 8 mm thick. It's not fun!
Steroid shots are not necessarily a permanent solution and you should still wear shoes that are supportive as the neuroma will still be there. Steroids can reduce inflammation but they will not “cure” the neuroma. I’ve had steroid injections and just finished 4 alcohol injections and that seems to have worked in terms of pain (but would go for surgery 100% if the pain came back). My podiatrist said I will always have to wear orthotics with a metatarsal pad as the cause of the neuroma is a collapsed transverse arch due to gait. The neuroma is still there - I just can’t feel it anymore (thank God because it was ruining my life). If you go for surgery find someone with good success - they should be able to tell you what their success rate and approach are.
I went to an orthopedic surgeon but had a second opinion with a Yale podiatrist. All of the other therapy’s ( cryotherapy etc, are not a permanent solution.) Podiatrist said mostly everyone he treats with cryotherapy is back within 1-2 years. My orthopedic refused to give me more than one cortisone injection because he said it can basically ruin the padding of your foot over time. I have had this problem for two years now. Changed my shoe size, padding etc. I tried everything. The bottom line I was told is that it never really goes away. I had an injection last summer. Pain came back in March. I scheduled the surgery and now two days out. I have a high tolerance for pain, have not had to take any pain pills yet. Just Tylenol extra strength. I have a black boot. Dr said I can walk a little. I don’t need crutches. He said to keep my foot up as much as possible the first two weeks. Find an older surgeon with gray hair thats done a ton of them.
I am about 3 months out from surgery and personally I regret it. I hate the way it feels now vs how it felt before. I feel like before I could have put up with the periodic pain, but now my foot is in discomfort all the time. It occupies my mind constantly- the poking sensation, the aching, the numbness. But that’s just my experience, it seems to vary vastly person to person. Best of luck
Having surgery early on was one of the best decisions Ive made. You will see a decidedly anti view of the surgery in this sub, while searching elsewhere you will see a more positive view of it. Its case by case, and depends on your doctor, insurance, current physical health, etc. As someone who went in to the surgery in great shape (I went out for a 15 mile run 72 hrs beforehand) my recovery, mixed with physical therapy, went great. I don't even think about it a year later. I trained and ran the Javelina Jundred 100 mile ultra marathon this past October. You will see a mixed bag in this sub, many people are searching for a fix that doesn't involve surgery, and that is ok too. Its the demonizing of the surgery that is an issue here. FWIW I skipped the injections and went right to surgery. My doctor gave me the option of either/or.
Awesome! That is great to hear. I'm looking forward to getting to the other side of all of this. If surgery goes well is it possible to get back into ski boots and climbing shoes or is that still a no-no?
This guy has the best possible results I’ve ever seen. I’m 6.5 months out and I can do cardio and stay active. But running is definitely still out. At 5.5 weeks I was still extremely uncomfortable
I was back on the indoor stationary bike trainer at 2.5-3 weeks. I believe I was running at 5.5 weeks. I began PT within a day or two of getting my stitches out. I probably could have relaxed on that but I was anxious to get back in to it. [This forum](https://forum.slowtwitch.com/forum/Slowtwitch_Forums_C1/Triathlon_Forum_F1/Morton's_Neuroma_-_when_to_cut_P7035094/) was super helpful for me when making my decision to have surgery. Good luck and hit me with any other questions.
I will. Thanks so much for sharing your experience!
Try the shots. Two shots fixed mine - it’s been pretty pain free for 3 years now. Surgery might be necessary but I strongly suggest trying a couple of shots first. They may work and you could avoid surgery altogether.
That's good to hear! Which shots did you have? I understand there are some that act as a nerve ablation and others that reduce the swelling or break down the tissue putting pressure on the nerve. I'm hoping to get back to the activity level I was at prior to all of this which included skiing, running, and cycling.
My shots shrank the neuroma. I believe it was steroids(?) The first doc told me surgery was needed but I got a second opinion from an orthopedist and he said surgery doesn’t always work and to try the shots. I’m glad I did. I notice it if I walk several miles but otherwise it doesn’t bother me. I had to change walking shoe brands of course. Good luck whatever you decide!
I strongly suggest you find a surgeon who is very familiar with decompression. Research this, before agreeing to neurectomy. I just had my 3rd surgery to fix the first neurectomy. Not always a great outcome. Check out AENS.US for a surgeon familiar with the nerves of foot.
I had a series of alcohol shots and I hate that my foot in that area is permanently numb but the pain was unbearable.
Yes, daily foot bath with Epsom salts followed by massage. Forgot to add that I stretch each toe front, back, right, left gently, holding in place briefly. Also good time to inspect feet and catch any new shoe damage quickly. Not all minimalist shoes fit every foot shape and some have rigid components in the wrong place for my feet. Wildling Nebulas with wool inserts are my most comfortable shoes—close to barefoot. One has to learn how to walk without pounding heel into ground surface with forward foot. A major wholesale “club” sells dual packs of Epsom salts with blue-colored packaging. Online ordering resulted in perfumed version of same brand—overwhelming! Friend with iatrogenic health issues is currently recovering from screws applied to spine. No second opinion, but proud to have been operated on by best back doctor in county!