I’ve searched and found a few threads about the alcohol shots to treat a neuroma. Seems like it takes 5-7 weeks, 65-70% success rate, and they can still recur is what I gather. I couldn’t find anything from people who had the surgery though. What is the success rate? What is the typical recovery rate? Do they ever recur or do you cut out the entire nerve? I’m interested in hearing from the good doc plus anyone who has had it done that can give me some anecdotal stuff about it.
Thanks.
As I need the surgery as well this is of interest to me. My ortho was not thrilled about the alchohol shots. More like a bandaid and not a cure. I was told by another that had the surgery that it was great and she was back in the water after 4 wks, bike in 6 wks and running in 8 wks.
Nerve resection surgery is about 75-80% successful in the literature (and I agree - about the same in my hands). The theory on failure here is either: stump neuroma regrowth, wrong initial diagnosis, or failed surgery. This has been done for 50+ years, so lots of data/studies, but some newer controversies as well that I won’t go into here.
Time off after surgery is usually about 2 weeks of nothing (no shower, etc.), but you can walk. swim in about 2 weeks. Bike varies a LOT but 2-3 weeks to start trying. Running can be tough for up to 4-6 weeks or more. Not a very complicated or difficult procedure for the patient and/or surgeon, but the devil is in the details with this surgery and you want someone who has done a lot of them.
Good luck.
BTW, there are only 2 published studies regarding the alcohol sclerosing injections for a Morton’s neuroma (by Dr. Gary Dockery at Swedish med ctr in Seattle). I know him personally. OK success rate (but I’m NOT seeing his published rate(s) based on my own experience of perhaps 70-85 patients).
No shower for 2 weeks??? Geez. I usually don’t go more than 10 days or so without bathing.
Seriously, why is this? The wound can’t be dressed well enough that you can get your feet wet at all?
Ha - sorry, typed quickly between patients. You can’t get the incision wet for about 10-14 days. You can certainly shower (but keep the dressing dry). I don’t use absorbable sutures for this type of surgery (for reasons I won’t go into here), so they will have to be removed in about 10-14 days.
I had surgery on the one in my right foot about 16 years ago. The only time I even notice it anymore at all is if I wear too narrow of shoes for too long or heels for too long (assuming you’re a guy–this shouldn’t be an issue 
). I was a collegiate tennis player when I had mine done. Recovery time to be out playing again was about 2-3 weeks. I had complications that went on further b/c I got a staff infection in my incision. But, the actual surgery (once they got the correct foot in the hospital) was no big deal.
I also have one in my left foot that’s been controlled w/ cortisone shots (actually only one shot thus far about 3 years ago). I’ve found that wearing shoes with wider toe boxes and lower heels (when not wearing running shoes) helps a LOT. And, you can get some inserts for your shoes that will take the pressure off of the metatarsals and the nerve as well. I think a company called Lyncos makes them?
Thanks for the info. Yes, I am a guy, so I rarely wear high heels. Only on really special occasions.
I’ve had two cortisone shots - they had no effect at all. Had custom orthotics made as well with a depression under the metatarsal - no help either - just a big waste of money. After going 6 weeks without even being able to run 1/2 mile before I would be stopped in my tracks by what felt like 1000 volts shooting out through my toes, I finally found a way to run. I have to wrap the metatarsals in a thick ace bandage so there is a ton of padding on there. I cut out most of the forefoot of an old running shoe so I can get my foot in there. It still hurt like hell to run, but I was at least able to withstand it - not the “voltage” type pain - to get me through IMFL. But not a long term solution, so I am going to get either the shots or thinking about surgery.
That’s about how bad mine was in college–when we finally opted for surgery. While I would certainly only use it for a last resort, it it’s that bad, I’d do it. It’s not a big deal. I was on crutches for a few days, told to stay off the court for 2-3 weeks. It felt fine when I went back out. I just had a reaction to the dissolving sutures and developed a staff infection. If that hadn’t happened, I would’ve been good to go. It’s normally a quick recovery–that’s why we picked doing it over the Christmas break—so I’d be back and ready for the spring season.
Just be sure you read all the hospital instructions BEFORE they give you any drugs. Seriously, they had everything set up to operate on my left foot instead of my right.
The one I had in my right foot in college that I had surgery on was so bad I could barely walk. I also had tried cortisone in that one and it didn’t work. The one I have in my left foot isn’t nearly that bad (yet).
Basically, what they do is cut the tumor out and move the pressure point back in your foot to where you don’t notice it. You may notice afterwards that you don’t have “all” the feeling left between your third and fourth toes–but it’s not totally gone–just a little deadened. But, they’re toes so who really cares?
Yow. Sounds like a bad episode of ER or something with them almost cutting open the wrong foot.
Mine is actually between the second and third space - I guess that is far less common then the 3rd and 4th like yours. Did you try the alcohol shots before you had surgery and not have any luck? Or did you just go straight to the knife?
I’ve had the cryo-surgery done twice for the same neuroma. The last was 2 weeks ago tomorrow. So far it seems unsuccessful. I have a follow up with the doctor tomorrow. I’m not sure what I’m going to do. Ughh!
No alcohol shots–I’ve actually never heard of those. Is that new? Remember, I had this done a LONG time ago. Just two cortisone shots. They’d work for a week or two and then owie. So, they scheduled me for surgery ASAP. Gotta love college sports.
Yeah, scary in the hospital. I was like, “uh, y’all mind operating on the correct foot?” Geez.
Good luck. I’d say if the new shots don’t work, get it cut out. Even if you have to take month off, (1) now is the time of year to do it and (2) it’s much better than being in pain for longer!
That sucks. What did the doctor say was the reason it didn’t work the first time? Or did it work and then it came back later?
It is not 100% successful. Rates are around 80%. I’m likely a bad canidate. First cryo was about 2 months ago. Damn I wanted this to work. I’ve had the cortisone injections, ortothic, no results. Shoes don’t matter either. I’m bothered by it barefoot too, cushining does help. I will continue to provide feedback. I’m just really tired of dealing with it. Cryo may work for you and others, and I think it may be an alternative to the removal.
Good luck
Larry
When you say “cryo” surgery I guess this a different type of surgery than the standard one. I didn’t catch that the first time. You say it is an alternative to the removal. By removal I assume you mean the resection of the nerve that rroof was describing above. What is the cryo-surgery? This is something new I’m not familiar with. I assume by the name it is somehow trying to freeze the nerve?
http://forum.slowtwitch.com/gforum.cgi?post=1082764#1082764 Take a look at the thread. Cyro is an alternative treatment procedure relatively new.
Larry -
Thanks - I had missed that thread. I will hit the net tonight and read up a bit. This is the first I’d heard of the cryosurgery.
rroof -
What is your take on the cryosurgery? Do you perform it? I’m guessing not since I don’t think I’ve seen you refer to it in any of your posts on this subject. Any thoughts on it anyway, especially as an option to the alcohols shots or removal?
Thanks.
No - I don’t do the cryosurgery. Basically, I don’t do any office based surgery - only hospital based. Since the vast majority of Morton’s neuromas respond to conservative therapy, if I’m discussing “surgery” with a patient - then that is what we do (i.e. resect the nerve). The cryo does the same (kills the nerve) as surgery or even the alochol sclerosing injections. But, often docs that do this in the office are quick to jump to it since they often either: 1) have no hospital priveledges (run away) or 2) have to pay for the cryo unit. Actually nerve resection surgery pays the LEAST of any of the modalities (even the alocohol injections) and most surgeons do not like doing it, but it is likely the most effective (again, assuming correct diagnosis, failed conservative tx, etc.) Also, there is not a lot of studies regarding its effectiveness as of yet (but that does not mean it does not work).
You will get many opinions regarding this treatment and that is why it is always good to get a few.
Good luck