So, it’s been 14 weeks since my neuroma was diagnosed. 3 Cortizone injections to the top of the foot, another month of Naproxen, still not fixed. Sought a second opinion. New doctor immediatly ordered a MRI. Same conclussion “Moderate amount of T1 intermediate signal soft tissue interposed between the heads of the second and third metatarsals with corresponding T2 increase signal which is best demonstrated on the STIR sequence. This appearance and location suggest the presence of interdigital neuroma interposed between the second and third metatarsal heads.”
New doctor with the visual of the MRI decieded to come at it with another shot of cortizone, but this time from the bottom of my foot. His recommendation was to hit it with this cortizone injection. If this does not work, surgery.
Your opinions… I think I would get a third opinion with the MRI available before undergoing surgery. He’s not a firm believer in the alcohol injections. As a sports medicine specialist, his thoughts are; Have the surgery during the winter, recover and have a better chance of having a full season of racing rather then take the chance of having the temporary “fix” recur mid season.
If time, offloading, shoegear changes, 3 (now 4) steroid injections have not helped and with your MRI findings, get it out.
Most of the neuromas that I take out I don’t bother with the MRI because it is often a false negative anyway since they are so small and hard to see. If yours was THAT obvious on the MRI, the perineural fibrosis (the technical term for a Morton’s neuroma) must be quite advanced. This is also why the “cortisone” injections have not bee very helpful. They simply decrease the nerve inflammation. The sheath around your 3rd common interdigital nerve is now “scarred” or fibrosed large enough to show on the MRI - you have 2 options here: live w/ it/suffer or take the damn thing out.
Off season in an active and healthy person - take it out. You should do fine with no long term problems.
As a side note. We had a horrible snowstorn on Wed night/Thurs morning in my area (Cincy). Level 3 emergency, closed everything. Had 3 surgeries scheduled in the morning. Hospital calling to cancel - staff can’t get in, no aneshesia. I barely got out of my driveway with a 4x4 SUV. One of my patients made it in anyway just in case I could get there and wanted to wait - she was a neuroma surgery. I did her other foot about 8 months ago and she was so happy. She had planned this foot for around the holidays. She was quite dissapointed and was willing to wait there all morning with her father (who got her there in his Range Rover) for me and the surgery team.
So there 'ya go! Be done with it! Now as a disclaimer: not all surgeries are like this. Some can/may have some ill after effects (espeicially for Triathletes), but very unlikely w/ this in experienced hands.
I went through the same ordeal as you and finally could not wait until it was out! I have an appt in Jan to see another doctor, I now have another one on my other foot! This time I have not waited as long as I did on the first one. I am hoping I am getting it taken care of in time to avoid the surgery. Good Luck to you and better now than later in the season.
Darn, you guys are scaring me. I had a nueroma many years ago. I went to a leading sports ortho doc. He had me wear a well placed pad under the ball of my foot and a pad in between the 2 toes. Eventually I removed the pad under the ball of the foot. A few months later I removed the pad between the toes.
He also recommended running shoes be replaced often, due to the breakdown of the bottom of the shoe. My running shoes must have a stiffer bottom so they don’t flex much. I also notice a slight “twitch” if I wear shoes that are too tight. I have to watch the size of my cycling shoes. Many shops and cyclists recommend a quite tight shoe fit. If I do that it mashes the toes together and I get the twitch.
Getting Old - don’t worry, that is the usual/normal course of a neuroma. Most don’t have to “come out”, but there is also no reason to suffer for over a year if this can be resolved with a relatively simple operation. Everyone is different - again, a fellow triathlete doc/surgeon should be able to guide you in your best interest which may or may not be surgery. Not that this is an easy person to find mind you … trust vs. training vs. money etc. Not easy.