For those of you who don’t remember the saga of the Morton’s Neuroma…
I was laid up for 16 weeks with extreme pain in the left foot from a Neuroma…
I visited 5 Dr.'s in total… The 4th wanted to cut open my foot… I quickly searched for a new Dr.
The 6th cortisone shot, the 1st from the last Dr. cleared it up in 1 day… Went in with pain, Left the office without pain and (knock on wood) haven’t had pain since.
So over the past 10 weeks I’ve been ramping up again. I’m running 5x a week 3 X’s on a treadmill 2 X’s road. Longest run 1:20 so far…
I’ve noticed that even though I don’t have any pain, I do feel a small lump and maybe a little “heat” build up in the place of neuroma. Not pain, but I’d imagine that if I let this go, it will turn into pain…
Is it scare tissue build up? Wouldn’t 6 cortisone shots break up any scare tissue from the Neuroma? Should I try to break up that scare tissue if indeed that’s what it is…
The “official” name for a Morton’s neuroma is perineural fibrosis. Under pathological analysis, the perineurium (outer sheath/lining of the nerve) is very thick and fibrosed or scarred. I have taken out neuromas as large as my little finger (normally the size of say thin spaghetti).
Normally, I wouldn’t do more than 3 corticosteroid injections to try to resolve a neuroma. Several studies on injection therapy for neuroma treatment support this. The theory here is to rapidly decrease the nerve inflammation so that it can heal (amonst other biomechanical issues at the same time). Problem is that neural tissues heals VERY slowly compared to most other tissues, if at all. Also, multiple steroid injections near the plantar forefoot fat pad will cause it to atrophy, further aggravating forefoot pain and metatarsalgia in general.
Once you can literally “feel” the nerve “scarring”, the steroid injections usually only give temporary relief. Now that “temporary” relief could be 6 months (and in that case if you had a steroid injection once or twice a year forever well …) Your 6th and “magic” injection was probably just timing and little else.
Peripheral nerve surgery never sounds fun, but if you had failed biomechanical control first, then 3 steroid injections, then elected for the surgery (with quite minimal long-term side effects I might add), you would have likely been healed well before the 4 months that you have been dealing with this. Plus, the chance for recurrence would be much lower (although not nil). This is a completely outpatient procedure and most patients walk the same day - sutures out in 2 weeks, back in shoes then. Many patients resume light running/biking within 3-4 weeks (with some discomfort for sure, but no more than before the surgery).
Best of luck to you! I’m sure you have read all about this on the net since this is an exceedlingly common pathology.