I had a shot and then went with the metatarsal pad on an insert. The pad worked really well for a couple of years. After a 50 mile race, nothing seemed to work and I wasn't going the shot route since it was temporary. Basically, when I got to the point that I couldn't run for longer than 20 minutes without pain having tried shots/pad, I got the surgery. I had surgery on both feet (about 6 months apart) over 15 years ago and I've been great ever since. I was riding within a week (not doc recommended) on the trainer, feet on top of the shoe and running in less than 3 weeks.

Do you think it was extreme to wait until you couldn't run without pain after 20 minutes? You must have gone months where 80, 60, and 40 minute runs were causing issues.

How long between getting the surgery and an A race do you think is too short?

I had it back in 2011. First it stopped me from doing intervals. Then from running altogether. Then it started to hurt when I was walking. After the surgery I haven't had any issues. Think it took 2 weeks before I was back to training again.

Ask them to go in from the top though. Doc who did me initially wanted to do it from under the foot. Luckily dad is a surgeon and convinced him to do it the proper way.

I am right with you there. Got my first shot last month and seemed to work for only a week. My doc said if that didn't work he might try something stronger before going another route. I am just happy that it hasn't prevented me from running but I do wonder if the discomfort has impacted how well I am run. Even though I can't really feel it when running it has to be taking something away from me. I have the Chicago Marathon next month so I would love another shot to get me through that then see what the doc says.

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I was thinking surgery after decades of pain

I posted here. One guy messaged me he couldn’t walk for 3 months after.

Another person posted they bought shoes 1 to 1.5 sizes too big and used a certain inside from amazon

I got a pair of shoes a full size too big and the insoles. Happy to say I can now run pain free. Did 13 miles a few days ago

Anyone need 6 pairs of lightly used size 11 shoes lol

I had it for several years about ten years ago and then Dr. Perry Julien gave me three B vitamin shots in the nerve. Has not come back since. Contact them for more information.

http://atlantafootandankle.com/..._foot_and_ankle.html

Did try steroid shots and other things to no avail. If it ever came back, this would be the first thing that I would do.

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Timely post. I have what I think is the onset of Morton's Neuroma, self diagnosed from Google ;) I have booked an appointment with the Dr. but that is still a few weeks away.
I will be interested in your results depending on the direction you go. I have no pain currently but my toes go numb about 5 km into a run. I can't really feel it walking in my daily shoes but in bare feet it is evident.
From what I have read there is the potential for the toes going permanently numb post surgery. That doesn't sound very appealing at all.

I had the surgery done at the age of 26 - I was having tremendous pain while cycling and when running the foot would go numb altogether.

I had a great surgeon who diagnosed it when I went to see him - we did a shot and it lasted about a month and it came back, I did basic research and asked for the surgery right away as I didn't want to deal with it (you also could feel the enlarged nerve pretty easily by hand).

He did the surgery from the top, had about a month off of running/cycling and have never thought twice about it again. It is completely healed for me. It did take about a year to get all of the feeling back in my toe and during that time I did have some phantom pain but it went away as the feeling returned.

I would recommend it for anyone that has some downtime and has been suffering with the issue - I have since been able to train for 3 fulls and roughly 6 halfs without any foot pain.

Yeah, based on what I know, I would have opted for surgery right away. You're right. I was running for too long with the pain. The surgery is so easy that it would be a no brainer to get it if it happened again. The reason I say that? One of the things a doc will tell you is that once it's removed, a new one can grow back. You become Wolverine in just the way you don't want to.

Update? Did you get surgery? I have mine scheduled for Thursday and am freaking out at the possibility of not running for 2 months! I wish I didn't want this long for mine. It was never painful enough to keep me from running so I just dealt with it. Then late December all of a sudden it was super painful and didn't run for a month. Now I can sort of run but still hurts. Got an ultrasound to confirm and surgeon basically said it was the only option since I had done all of the other things. Never thought I would be happy about having surgery but after 1.5 years of this I cannot wait to walk/run pain free. It will be a bit weird!

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Yeah, i got the surgery. What a journey.

I got the surgery in November, and didn't start base training until January. I lost a lot of fitness, and a lot of strength on the leg that i got surgery on. Turns out, i had a very unusual case. On top of the typical enlarged neuroma, my surgeon said i had an extra nerve that was wrapped around the typical neuroma nerve. I'm like Wolverine from X-men, except i just had an extra nerve in my foot that had a chokehold on another nerve. Neat.

Let's talk about some cons. Just going to bullet point them out.

• I fell a couple of times on my push scooter. I landed on my foot to catch myself, which sent a shock wave (like a more painful funny bone), up through my leg. Doctor said that it was fine, and he expected me to fall. We're bipedal after all. We aren't much good with one leg.
• It was painful to walk after 8 weeks. The weird thing was, i felt pain in my heel - sort of like plantar faciatis. Weird since my heel wasn't part of the surgery, and we removed the nerve from the topside. The doc said it is normal for your foot to feel pain when you start walking after you have not walked in a long time. The pain in my heel would go away after i started to walk on my heel, and it would decrease day after day. Same sensation with the ball of my foot. Same sensation with bending the ball of my foot. Same sensation with jumping and bending the ball of my foot. Nice slow recovery walks helped work out this issue.
• I went for a 50 minute run yesterday in z1 or z2, and my foot felt generally sore. I'm not sure if this is due to surgery or if the muscles in my foot are weak.
• Last night, i got the occasional twinge in my foot near where I had surgery. Not painful, but a little annoying.

What are the pros? I've been able to run and bike about 7 hours a week for the past few weeks. I'll consider it a complete success if I am able to get to nationals without seeing the foot doctor, but so far, so good.

Let's talk about the things that helped my recovery.

• Fuck crutches. Get a knee push scooter. For my mental health, being able to get around quickly helped a lot. I hate being slow, and your arms will get very sore from hobbling around.
• With your remaining time before surgery, do some squats. Especially single leg squats on both legs. You will be doing single leg squads for the next few weeks anyway.
• My bandages after surgery were waaaaaaaaaaay too tight. My foot hurt more from the bandages from the surgery. I called the doc after two days, and he said "yes, please loosen the bandage." Luckily for us, the spot where we would feel the most pain from the surgery is getting removed, so there is that.
• I wouldn't prioritize elevating your foot over getting some good sleep. The morton's neuroma facebook group are junkies for keeping your feet elevated, but i couldn't sleep with the boot and my feet propped on many pillows. So i took the boot off when i slept and did whatever i could to sleep comfortably. Unless you are elderly and unfit, swelling isn't going to delay your recovery. If your foot balloons to twice its size, then yeah, you have a swelling issue, and see a doc.
• I'd recommend getting a light pair of stiff running shoes for when you will be able to start walking again. Hokas did the trick, but not because of the cushioning. Like I said above, i found it painful to bend my foot, so the light hokas allowed me to walk without flexing my foot too much.

So far, i would consider getting the surgery again. Good luck and speedy recovery.

Glad to hear you are on the way back! How long before you were able to bike or swim? I am hoping my surgery is pretty straight forward and based on the ultrasound the surgeon didn't seem to concerned with anything thankfully.

I am lucky that I am going to be taking over a week off of work so I don't need to be on my feet much for like 10 days outside of what I will be doing at home with my daughter. Sleep will also be ok I am sure since I can nap throughout the day. I just hope I don't go crazy being in my house for so long!

I was looking at the one leg scooter things but wasn't sure how long it would be before I could actually walk semi normally so didn't want to get it yet.

I will need to get a new pair of shoes that are a bit wider to accommodate my new fatter foot! Thanks for the suggestions though! I hope that I can get back to semi normal stuff after a 6 weeks so I don't lose too much fitness but I also won't rush back.

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I didn't have access to a pool, but I did a light spin on my legs after 4 to 6 weeks.

I have a desk job, so i only took a couple days off.

Another thought about the scooter is making sure you have a car where it will be easier to throw it in without dissembling/bending it. I did use crutches for places that required more dexterity, like getting around the house. But out shopping or at work - scooter. Oh, i also forgot to put clip-on aerobars on my scooter. Do that and post it on reddit, GTN, or facebook. Say something about a speedy recovery, and i'm sure you'll be internet famous.

Ha! I do have an extra set of aerobars collecting dust! I wonder how much the extra nerve had to do with the longer recovery. But I will know in a few days once I get out of surgery what it looked like when he was in there. I wish I would have gotten mine done right after my last race so I could be recovered now not wondering if a 6 month lead up to the Chicago Marathon will be good enough for me. Oh well. It will be nice to run pain free after I am recovered.

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Have you explored alcohol sclerosing injection treatment for morton's neuroma? It is minimally invasive, it has zero down time, and it has none of the very significant risks of foot surgery. I had it done for very problematic neuroma and l am now well over 10 years pain free.

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I have. Two docs talked about it and main podiatrist said it is hit or miss and makes surgery harder to do if it doesn’t work. Also entails a shot a week for like 10-12 weeks which is a lot of time to give to something that might not work. After having this for over a year I didn’t want to chance it since it now painful to walk. Never want o be cut open but cannot imagine going through this for another few months before it possibly gets better.

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12 shots?? That is weird, l had just 5 shots ... and l was totally good. Most studies mention treatment with half the number of shots, not 12. Also, l never heard anything about the alcohol treatment making surgery more difficult. Did your podiatrist provide more info about that statement? Also, regarding the 'hit or miss' statement, studies seem to indicate a success rate of around 90% for the alcohol sclerosing, which seems way better than 'hit or miss':
https://clinicaltrials.gov/ct2/show/NCT00284583

Surgery is a big decision, about surgery vs alcohol treatments, were you able to get a 2nd opinion from another podiatry office?

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Yes I got a second opinion and actually a 3rd. My original podiatrist was NOT what I wanted. He suggested surgery from the bottom of my foot which after talking to two other surgeons and a few PT friends was told that is the worst idea possible! So happy I saw a few more people. I was very happy with my appointment with the ortho surgeon I saw on a recommendation from a top sports surgeon in the country so I went ahead with it because I was just completely ready to get rid of this even if it meant being cut open. For me that is a lot because IVs are my worst nightmare! How big was yours? Mine is 1.5x1.2cm so maybe size was part of the issue.

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Well, sounds like you definitely did your homework. Yes, my neuroma was a lot smaller than yours, so that might explain your treatment recommendations. Good luck with everything and maybe report back later!

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Thankfully I got a few more recommendations or else I would have been SOL with the first podiatrist. Maybe I will make a thread with updates everyday since I will just be at home sitting on my ass for a week before I go back to work! Thanks for your suggestions though! Love getting other's points of view on things so I have more information.

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No worries, l definitely would like to hear what your experience is with the surgery and post. I just had a pretty remarkable success with the alcohol injections, so I figured if I could help someone else avoid surgery and a long rehab, why not?

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Good to hear. I've been having what I think is MN for about 6 months now. I saw someone (health care biomechanist actually--thinking it was from a funky foot landing)...about it & said it was metatarsalgia, but the symptoms seem to stem between the 2nd to 3rd smallest toe on the underside of the foot--then a burning across the base of the toes to the ball of the foot, which also sounds like Morton's. Icing & Advil doesn't seem to do the trick. I may need go see a podiatrist as it doesn't seem to be getting a lot better even with rest.

How long were you out of running Neal?

Interesting study, the clinic in this study abandoned injections due to lack of success by the majority of effective results (25 fails to 7 successes from alcohol sclerosing therapy).

https://www.ncbi.nlm.nih.gov/pubmed/21733418

Sounds like surgery is the best way to go for MOST of the folks who are being crushed by this issue.

See a podiatrist yesterday. Bonus points if they are a runner.

The main risk you will be dealing with is that if a neuroma goes untreated, the nerve can build up scar tissue. The time frame is usually wearing very tight high heel shoes over years, so you are probably still in the early stages. The way to reduce the swelling nerve is 1. not to agitate it and 2. get a cortisone shot. Scar tissue will not decrease in size, cortisone has no effect on scar tissue, and a large neuroma from scar tissue will become more agitated.

Imagine that you are in your first year, and your nerve is swollen 100% due to inflammed nerve. You'll respond extremely well to cortisone, and will likely not need to ever come back.
After a year of not treating your neuroma, the size of the neuroma is 80% due to inflammation and 20% scar tissue. You'll still respond well, but you'll be more likely to develop a neuroma in the future.
If never treated, the neuroma will get so large that it become extremely painful, and you can't shrink the scar tissue with a cortisone shot.

So in the early stages of a neuroma, you might just need to change your shoes and get a cortisone shot. Cortisone shots are cheap and may feel uncomfortable for a few days, but then you are back to running. It is only after cortisone shots stop helping, i.e. you have a large neuroma from scar tissue, that surgery becomes necessary for recovery.

Alcohol shots are more of an experimental therapy designed for amputees who are dealing with nerve pain. They are expensive because they require a series of shots over a long period of time with a very low efficacy. Ditto goes with cyro therapy.

If cheap conservative options have not worked for you over a year or so (changing shoes, e.g wider shoes; new inserts?; cortisone shots) then surgery is the way to go. There are two primary surgeries you can look into - a neuroectomy and decompression. Decompression is newer, and fewer docs are familiar with it. The advantage of decompression is that you are loosening some ligaments in the foot, not messing around with cutting out a nerve. I wasn't persuaded by decompression, and had a successful neuroctomy.