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.
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?
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.
I’ll echo your “get it dealt with ASAP†thoughts. I waited and waited and waited before I saw a podiatrist because it wasn’t that bad and didn’t really hurt much. That’s part of the reason none of the other solutions have helped. Now the damn thing is huge!
Surgery got moved to tomorrow instead of Thursday so I’ll just be freaking out for the next 24 hours because I HATE IVs!
How long were you out of running Neal?
I was out for just under 3 weeks from running although that wasn’t doctor recommended.
How long were you out of running Neal?
I was out for just under 3 weeks from running although that wasn’t doctor recommended.
As long as stitches heal–I’m all for aqua jogging! I usually AJ 1-2x a week when not dealing with injury just to save on the damage to the body. In fact, I’d say it’s the main reason I can get away with so little road mileage and still have decent runs, I’m not as beat up as others my age. Making an appointment with a podiatrist in 1-2 weeks!
I will keep this thread updated with my recovery as reference. Had surgery today. No issues besides them missing a vein on one side and me almost passing out because of it. Wife got a funny video of me after I woke up that I don’t remember. 21 minute total time. Nerve was “angry”. Saw the nerve post op and looked crazy! No pain yet but have prescription filled with Norco, a stool softener, and a high dose slow release Advil. Am able to walk on my heel with special boot. Doc told me to stay off it today but tomorrow move around and to not just sit on my butt all day. I expect tonight will suck once I get the feeling back in my foot. Crazy how easy the actually surgery was now hoping the recovery is straight forward too!
Good to know & thanks for the updates. After 6 mo. of just annoying discomfort (not really anything I’d call pain but enough to make it uncomfortable running), and reading up on this…I’m convinced/self diagnosed it is NOT metatarsalgia and is actually MN. Seeing a podiatrist tomorrow.
jrielly–so they put you “out/under” and it was a local anesthetic?
Mine started like that too. Just an annoyance or discomfort that every now and then hurt so I didn’t really feel the need to get it looked at. Then finally saw a podiatrist last April and tried pads and that didn’t work. Then one not as strong shot that didn’t work. 2nd steroid shot worked for 6 weeks then after the 2nd steroid shot all hell broke loose and it was very painful to walk and couldn’t run for a month. Finally last month made the decision to get it removed.
For surgery I was under for the whopping 21 minutes! My surgeon said the next few days are going to suck but thankfully nothing too bad so far. Have only taken 1 Norco every 6 hours or so but not very painful so far. Sleep sucked because I couldn’t get comfortable. I can wiggle my toes and flex my foot. Walking on the boot is slow but better than crutches.
Good luck with your podiatrist! I talked to the best foot/ankle surgeon in the country (Dr. Martin O’Malley) who operates on all the pro athletes and he does not recommend more than 1-2 steroid shots because they do not distinguish between good tissue and bad tissue so my guess it my second steroid shot degraded some of the good tissue/fat which meant I had not buffer for the neuroma anymore.
I know it will be a bit but I cannot wait for the day when I can run without pain! Those 6 weeks the shot worked were amazing. It will be a breathe of fresh air!
For surgery I was under for the whopping 21 minutes! My surgeon said the next few days are going to suck but thankfully nothing too bad so far. Have only taken 1 Norco every 6 hours or so but not very painful so far. Sleep sucked because I couldn’t get comfortable. I can wiggle my toes and flex my foot. Walking on the boot is slow but better than crutches.
Sleeping yeah. Don’t be afraid to take the boot off and just sleep in your bandage. I also found i got a lot of relief by laying on my stomach and bending my knee so my foot was still elevated. Then when i was almost ready to fall asleep, i would roll over on my side or back.
Glad you’re doing good so far. Don’t forget to post again after you start running. I’d like to link this thread to people who are overly cautious about getting surgery on the Morton’s Neuroma facebook page.
My doc told me to keep the boot off unless I was moving so that was really nice. It gives me a chance to wiggle my toes and move my ankle so nothing gets too tight.
And I’ll keep posting because I really wish there was more info out there when I was searching. Found a few threads but not much so would love to add another resource especially for runners.
What types of exercises or things did you do at home before you did PT? Not that there is much but want to make sure I keep things moving so I don’t lose all flexibility and muscle down there!
I stayed off my foot for three weeks, then walked a lot for physical therapy. Like i said earlier, I just ran 50 minutes this past week, and my foot was sore, so maybe i should look into some feet specific exercises. For reference, i am starting all over with my running on Berry P’s running plan. I started running 15 minutes six days a week, and that might be all of the foot exercise one needs to do. If you are going to jump into 30 minute runs at 7 min/mile, then you may want to look into foot specific stuff.
Got ya. I was going to get back slowly like you did. Walk, then walk/run, then run. Won’t chance pushing too hard and having to take time off. I am just more happy I am able to wiggle my toes and move my ankle.
I wonder which style of alcohol injection they did. Looks like there are 2 types. One with about a 4% success and one with almost a 90% success.
https://www.mortonsneuroma.com/blog/alcohol-sclerosing-injections-vs-alcohol-neurolytic-injections/
Day 2 update:
Was able to sleep through the night. Took 2 Norcos which might have helped. Not in much pain. Walking in the boot feels a lot better and forefoot is no as sore and can put more weight on middle of foot than yesterday. So seems to be getting better and better thankfully! Showering was super awkward because I was deathly afraid to get bandages wet even after I triple wrapped it I was still nervous.
Will keep the thread updated as my recovery progresses. But very happy that it hasn’t been super painful and that I’m able to wiggle my toes and move my ankle around. That was one of my biggest worries. Did not want my toes/ankle to be immobile during first few days post surgery.
jrielley–my update here is an xray & examination took place, no MN found, but ligament on 2nd 3rd toe seems damaged and stretched or possible small tear (short of an MRI), which may make the big toe appear “lower” than the others…when it seems 2&3 are actually higher. Orthotic altered by doc & will see if this helps the situation. Doc is a Sports Med ortho doc/surgeon podiatrist. So good news so far…going to try to run today with alteration.
Well good luck! Hopefully the adjustment will fix it and get you back to normal. Mine was diagnosed by the exam after X-ray ruled anything else out then was confirmed with the ultrasound 6 weeks ago before moving forward with surgery.
Get the surgery. This is the one surgery everyone says this wish they got sooner.
I apologize for the lengthy post but I just went through this ordeal and have a lot to say about it.
My doc only let me get one cortisone shot. Worked like a charm for 2 months then the neuroma raged back and she said it’s either surgery or nothing when I came asking for another. Couldn’t run on it, no amount of pain tolerance would change the fact that my gait was impossible to maintain with the neuroma.
Surgery required time off work- I only took 2 weeks and while I managed to make do at a somewhat physical job after those 2 weeks, people’s jaws were dropping with how badly I was limping (in the boot still) and 4 weeks would’ve been smarter if we’re being honest. The Dr. will likely clear you for 2-3 months (mine cleared me for 3) but realistically 3-5 weeks is typical.
Aside from walking a block or two when absolutely necessary I was off my feet and had the foot elevated above my head for 2 weeks and needed it. Blood would pool and cause pressure pain if the foot was down for even a second and those 2 weeks sucked. Weeks 2-4 I was still in a boot and barely walking but could take it off and bike at lower wattage on the trainer with a completely untied shoe but was walking minimally. Again, if we’re being honest, most people would probably not be doing any form of cardio until at least 4 weeks post-op, even obsessive ppl like us.
6 Weeks after the surgery I ran for my first time and was doing half marathon distance training runs within 2 months of surgery. Based on feeling I actually didn’t feel this was rushed although the rest of my recovery above probably was. The first couple weeks running were awkward and I naturally babied the foot but once I got comfortable I had no discomfort at all in any way and while several toes are numb I never notice it.
Running isn’t affected negatively at all whatsoever and I’ve had no joint stability issues (they cut several ligaments that will never heal).
It’s been 9 months since surgery now and
it’s been perfect. Ran a 3:30 during an IM exactly 18 weeks post-op and still feels perfect.
The scary thing with neuromas is that they can always come back. The Dr. made a point to cut as far away from the joint as possible so the ends never reconnect and grow back, but it can happen even years down the road. However neuromas don’t heal on their own and it will only get worse. You will never be able to run properly until you get surgery so surgery really is your only hope.