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Morton's Neuroma
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By sunder
From Alsip, Il
Oct 1, 2010
ICE PIT 2011
Hey has any one had any experience with Morton's Neuroma. I have it on my left foot between the 3rd and 4th Toes... Just like the picture below.


It really sucks! Imagine a small marble between the joint in your foot when you walk. It click, pops, snaps, and burns when i walk.

So far i have had two corisone shots with no luck. I think there going to use alcohol shot to try and kill the nerve now and if that doesn't work then surgury to remove it. :(

Does anyone have had any experience with this?

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By lisa c
Oct 2, 2010
Hi Sunder,
I had the same Morton's Neuroma in the same foot. It "built up" for years and years that began with numbness in my smaller toes. I had corizone shots, the alcholol "killing" shots, and lost count after 30 or so shots that usually left me more sore for 3-5 days with only a couple days of relief before it came back. It got to the point I couldn't wear climbing shoes very long and even hiking with orthotics left me hobbling and having to take my shoe/boot off every few miles and sit. I even had orthotics created with a metatarsal lift to take pressure off the neuroma. Soon I had to wear those every day with every shoe. So no dress shoes, no flip-flops, no climbing shoes, and definitely no going barefoot, even around my house.
After my second podiatrist said that basically removal of the nerve was my only option, unless I wanted to suffer though fifty more shots and be co-paid to death, I fired him and went on to my third podiatrist. He said there was a newer surgery wherein he could relocate the nerve and remove the scar tissue that had built up around it.
I highly recommend this surgery. Like any other surgery there is recovery time.
I was so happy that I could wear flip flops again that I bought 5-6 pairs and my tight climbing shoes aren't a bother. I still have some weakness in that foot but doesn't seem to impair my climbing ability much, and it also might be a completely different issue.

Email me if you have any questions. I've been through all of the available fixes and am so glad I didn't get it snipped as that surgery seems to just lead to more problems according to the research that I've done.

I'd say "get better soon" but that won't happen with that beast in your foot, I'm sorry to say.

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By Tradoholic
Oct 2, 2010
I got one from running. I placed a small adhesive bump in my shoe and then played around with placement until the pressure was relieved. Got 'em from a chiro but any running shop ought to have something like it.

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By Sauce
From Golden, CO.
Oct 13, 2010
slackline at the AAC Climber's Ranch
This is the most relevant post i have seen! I have not had the condition diagnosed but, feel sure i am suffering from it. For the past three weeks i have had a searing pain in the pad of my foot near the small toes. X-rays did not indicate skeletal damage, and i have since found this condition. i work construction and after i have been on my feet for an hour the pain becomes unbearable. There is lots of popping and then the pain, very unique..it feels like my foot is on fire. what are the initial treatments? is an mri required? do orthotics help? what painkillers help? its keeping me out of work and climbing and making me depressed. any help is appreciated!

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By Andrew Carson
From Wilson, WY
Oct 13, 2010
Gallatin Canyon
Yes, I had the same condition, same location. The surgery resolved it completely and I was on my feet in two or three days. I'd have to say I have absolutely no negative impacts from the procedure, and I went on with it for about a year before someone clued me into what it might be. The usual caveats for all surgery apply but it sure did the job for me.

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By Elliott Crooks
Oct 14, 2010
I'm a pedorthist: relationship to foot physician same as optician to ophthalmologist. I've dealt with a LOT of Morton's. To relieve the pain from a Morton's neuroma, you need not to squeeze the nerve; shoes/rock shoes need to not constrict side to side(not likely, the way most climbers fit their shoes), and metatarsal support ("bump" added just back of balls of toes [metatarsal heads]will help. Cortisone shots relieve the pain, but do nothing to help heal, and alcohol shots kill the nerve. Killing/severing the nerve will relieve the pain, but will also leave you without feeling/sensory feedback from those toes-which you do NOT want. Your small toes are major balance sensors, and you need the feedback. If you doubt this, watch the guys at AAC meetings who walk like Frankenstein-they're missing toes. I have to date no feedback on re-routing the nerve: sounds great if it works-ask for success rate statistics. More prosaically, getting your rock shoes stretched might help. I have to stretch my left shoes for my wider left foot. Good luck, feel free to contact me.

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By sunder
From Alsip, Il
Oct 14, 2010
ICE PIT 2011
So this is what i have done in the last 2 weeks since my orignal post.

I stopped at a new balance store since they are one of the few places that carries wide shoes in large sizes.

I bought 2 pairs of Dress shoes for work before i was wearing 12's now its 12 4E or 13 2E/4E I also use a Insole that has a lot of arch support to help take the pressure off the front of my foot.

Dress Shoes
shopnewbalance.com/detail.asp?...

Insole
shopnewbalance.com/detail.asp?...


Also picked up new boots to hike in and last weekend was the first time outside in a while outside walking without my feet hurting and limiting how much i was able to walk.

I think it was following boot i also bought the arch support.
shopnewbalance.com/newbalanceM...


With me my old dress shoes and hiking shoes was some of the cause of the morton neuroma flare ups... The shoe was just not wide enough. With wearing a normal shoe i wasn't allowing my fore foot to expand when i walk which aggrivated the nerve. Also the sole in my older dress shoes was wearing and breaking down which cause my 3rd and 4th metatarsal bones and Proximal Phalanges to sink/be lower in the shoe which moves the nerver into a position where its pinched and easily arragivated. Switching to a wider shoe helped me so much..

However by no means is it gone or am i completly painfree. Changing to a wider shoes minimized how much i aggravite the nerve during the day while walking.

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By Callie Rennison
From Boulder, Colorado
Oct 17, 2010
Had neuromas in both feet, and had them both removed surgically - one in Dec 2009, and the other in March 2010.

Yeah, there is a little tingly sensation that results, but certainly not enough to affect balance. The only time I notice it is oddly when I pull on a pair of socks. As I'm pulling the sock up, it feels like a thread is between my third and fourth toe. Not painful, just a little odd.

I can't speak to recovery from the surgery since I had them removed during some pretty good bunion surgery. By the time my chopped up and rebuilt feet healed, the neuromas were nothing but memories.

I'm 100% happy to have had the surgery done - no complaints and I certainly do not miss the pain.

If you are interested in what the incision looks like, I posted some photos on my blog. Scroll down to see the neuroma incision: daveandcallie.blogspot.com/200....

Good luck! I know that surgery is not for everyone, but at least for me, it was absolutely the right thing to do.

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By JoannaH
Oct 19, 2010
I had the exact same thing in both feet a few years ago. I'd been hiking with my toes curled up as the only way to relieve the pain for a couple years, then eventually everyday life required it. After orthotics and cortisone shots didn't work, and the pressure the bones put on the nerves had me in pain even sitting in my cube during the day, I decided to have them removed. It was the right decision for my particular situation, and the best money I've spent.

I was a good patient (critical!!! At least in my experiences) and stayed on my butt a few days, then was able to do a mile on a treadmill after a week. 8 weeks to the day after surgery, I was able to head up Rainier. A couple weeks after that, I was comfortable in climbing shoes again. I don't have touch sensation in two of my toes in each foot, but can completely feel pressure, and I don't think it affects my ability to feel little holds and whatnot at all. There's a funny tingle if I put acute pressure on one little spot in the middle of my arch as well where the nerve receded to, but it doesn't hurt at all. That seems to have been fading a lot over the last few years, too. The little string feeling described when putting on socks existed for a few months, but is now completely gone. My podiatrist is a climber, too, as well as a triathlete, and has had the same surgery himself after several rounds of the less-invasive options.

I'm sure it's not the best option for everyone, but it was for me. Good luck!

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By QdeBees
Oct 19, 2010
don't bother with alcohol shots -- painful and ineffective. orthopedists who saw my wrecked feet after 6 weeks of this treatment said, 'barbaric' and 'useless'.

be very careful about the cortisone - it can destroy the joint and leave you with a permanent disability. that is what happened to me.

I didn't get to have the surgery because these treatments left me with a much more serious condition than I started with. What I'll need now (assuming i trust a doc with my feet again) is major reconstruction and 6 mo to heal.

take some time off climbing and serious hiking. get on a bike and/or swim. if this doesn't work, go for the surgery but find someone skilled and experienced with the procedure. given that your doc is suggesting alcohol shots, I'd question whether that is what you've got and hunt up a second opinion. .

yeh, I know... but four weeks off is nothing to a permanent limp.

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By sunder
From Alsip, Il
Oct 19, 2010
ICE PIT 2011
Yeah i will probably get a second opinion. I really don't like the cortisone shots and the alcohol shots just don't sound good for you and they don't work. Im getting married at the end of April and i don't want to be crippled and in pain for the wedding.

Anyone know a really good doctor for this in Chicagoland area?

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By lisa c
Oct 19, 2010
Don't forget to find a foot surgeon who knows about the neuroma RELOCATION surgery. It tends to have less adverse affects than the neuroma removal.
Perhaps my podiatrist can recommend a collegue or someone he knows of who performs this more progressive and less risky surgery in your neck of the woods.
coloradofootinstitute.com/
Email Dr. Joseph Mechanik.

Good luck and happy healing,
lisa

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By sunder
From Alsip, Il
Oct 20, 2010
ICE PIT 2011
So i meet with the docotor today and we are going to stop the Injections of Cortizone and not do the Alcohol shots. I am going for a Ultrasound of my foot next thursday then they well determine if they do the decompression with relocate or the removal of the nerve if it is bigger that 2mm.

Lisa, Thanks for the info i will contact him.

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By lisa c
Oct 20, 2010
I think you'll be happy with the relocation and decompression procedure. If you have any questions about my recovery please email me.
Be sure to let yourself heal!

I had mine done last November and was ice climbing by February.

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By Sauce
From Golden, CO.
Oct 20, 2010
slackline at the AAC Climber's Ranch
How many shots until surgery becomes an inevetability? Neither Cortizone shot has helped with the pain. Does anyone have a surgeon to recomend in the Denver/Golden area for removal? Is there a lengthy post-surgery recovery? Ballpark cost of the procedure? Thanks for any advice or feedback.

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By sunder
From Alsip, Il
Oct 20, 2010
ICE PIT 2011
Spencer, Check out lisa c post 3 back. I had two shots in my left foot and one in my right. The pain is a bit better but not really. I told him that i didn't want the cortizone shot any more because they really destory the fatty tissue pad in the bottom of you foot and the joint too. The alcohol shots from my research seamed like a waiste of time and more pain and $$ to burn. So i ask him what my othere options were. He said surgury.



Lisa, Did they go through the top of your foot? i told the docotor that the bottom of my foot is off limit, i don't want the scar tissue on the bottom of my foot. Also what was your recovery like?

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By Callie Rennison
From Boulder, Colorado
Oct 26, 2010
Spencer - how about a recommendation in the Boulder area? It's not that much further than Golden, and I think my doctor is well worth the few extra miles.

Dr. Thomas Shonka of the Foot & Ankle Care of Boulder did my surgery. I would trust no one but him with my feet. Here is his info if you like:

facboulder.net/
1400 28th Street, Ste 2
Boulder, CO 80303-1096
(303) 449-2000

Good luck!

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By Callie Rennison
From Boulder, Colorado
Oct 26, 2010
Sunder - my neuromas were removed from the top of my foot. The thought of a cut on the bottom...ew.

For some reason I can't get the photo to load. Click here to see where the incision was. It's the smaller incision by toe 3 and 4. Warning: This is a photo with stitches still in. It's sort of gnarly looking. Here is a link: img=3.bp.blogspot.com/_R_v6k7xKves...

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By lisa c
Oct 27, 2010
Sunder,
Yes the incision was through the top of the foot, one incision about 3.5 inches right over the neuroma area.
I was in a tight wrap for a week, with crutches, then to a boot with crutches for about another three. Then I went to 1-2 crutches, with boot, for the next 2 weeks depending on how my foot felt. After this I went to the boot w/o crutches for another week then onto a nice soft bigger shoe for another three. Believe it or not when I could squeeze my foot into my ice boots my foot was well supported and was quite comfy. I still favored my good leg/foot for another couple of weeks or so.

It seemed the biggest challenge was ledges in rock shoes that had no support. On those early spring days I would get out on easy stuff, 5.6-7, and my gimp foot would "sink" out of overall weakness. After exhausting my foot after a day of climbing though it would feel exponentially stronger a day or two later. Wobble boards and balance disks worked well to get my foot strength back as did just climbing and walking.

Now, just about a year later there is slight numbness in that foot and an occasional and rare shooting pain that lasts a fraction of a second.
I still am VERY pleased that I had this procedure done.
The biggest risk of this surgery is "undoing" the relocation procedure in the first couple of months into recovery as the surgeons have to attach the nerve to something closer to the top part of your foot where pressure is rare.

I hope that was clear, let me know if you have specific questions.

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By JoannaH
Oct 27, 2010
I have a 2" incision on each foot (I did a 2-fer). I believe they always go through the top unless there's something else weird....

I was on my butt for 3 days, then in little surgical walking shoes that allow your to (relatively) comfortably walk on your heels. No crutches or boots ever. I could jog a mile on a treadmill after two weeks, and head up Rainier after 8 weeks. I still have no touch sensation on either of the two affected toes on eah foot, but pressure sensation and muscle control are like normal. It was a little while to get the muscle strength back (in a climbing sense) in the feet after the surgery, though. Maybe 4 of 5 months to get that all the way back.

For me in Seattle two years ago, after insurance, the total cost for both feet at the same time (which involved full anesthesia because local for the two feet combined is too much for the system) was ~$1200.

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By lisa c
Oct 27, 2010
One more note: the potential side-effects for removal (compared to relocation) scared the living crap out of me. After removal if you get the side effects I've read about over & over, they're horrible and there is no turning back-no undoing, you are in pain the rest of your life.
The extra recovery time for my relocation procedure was well worth eveything, the successful recovery and most importantly- the huge huge reduction of the risk of those side effects that the studies show that occur with the removal.

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By sunder
From Alsip, Il
Nov 6, 2010
ICE PIT 2011
So i meet with the doctor here the size of my neuroma's.

Right Foot 2.5mm
Left Foot 2.6mm

Normal ~1mm

So I am having surgery on Nov 19, both feet at the same time. He is going to try to decompress and relocate them. If he feels that he can not relocate with out causing pain then he will just remove them.

Not so much fun.

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By lisa c
Nov 7, 2010
Holy crap! I hope you have someone taking care of you for a week or so. It's going to be rough but you will be so glad that you did this.

May your surgery go well and your recovery be swift!!!

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By lynchdogger
Nov 8, 2010
Great to read I'm not alone but sorry that we all have had or are dealing with this pain!
I joke with my wife that I feel like the lion from that Aesop's Fable - in other words, I'm typically not a complainer but this issue has been debilitating.
I've done the custom footbeds and strength training but the pain won't go away. When it hits it knocks me off my feet.
I've grown very discouraged and although I thought the issue would be resolved after a cortisone shot just last week it came back and hit me hard yesterday after my weekly mtb ride. I was hoping this would calm things done for much longer than a week but from other's comments that's not going to happen.
Surgery - Aaaaaaarggh!!! Not looking forward to another surgery since I'm just recovering from foot surgery last August (foot was crushed at work but was lucky and I've had a full recovery). In fact, besides this neuroma issue and tendinitis in my elbows (isn't getting old fun), I'm in the best shape I've been in years - just in time for ice climbing and ski season!
Has anyone tried acupuncture or other alternative therapies? Are there any?
Good luck with surgery and luck to the rest of you dealing with this.
I'm going to suffer for awhile longer and deal with it late winter or early spring after the memories of my last surgery have faded further and after my favorite season.
I'll be checking in. Let's hope for lot's of ice and snow! Well wishes and good luck.

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By sunder
From Alsip, Il
Nov 8, 2010
ICE PIT 2011
Thanks!!!

Im going to end up missing most of the ICE season. Lame... I hopefully i can catch the tail end of it and maybe for once i can walk in my LaSportiva Nepals Boots with out it hurting.

Just found out from my HR Department that i could apply for short term disablity at work while i recover for a couple of weeks.... So i don't have to burn all my vacation days and then if it take longer that the 5-8 days im set while i recover..

Hopefully i can talk the doctor into taking some pictures during the surgery or at least some of the neuroma.

Lynchdogger at least start seeing the foot doctor to get things rolling, because they usually have to do a couple of cortizone shots first. That takes about 2-3 months. There not take painful, i was climbing at the red after shots in both feet. I just iced them the whole way down.

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By lisa c
Nov 9, 2010
Sunder, please keep us posted. I'm sure your recovery will go much faster than mine did, perhaps I had the worst-case scenario as far as recovery time.
And Lynch, accupunture may work but you have to keep getting it, which grows very expensive very fast and may not reverse or fix the neuroma. But give it a try, see what happens if you can afford it.
Basically, if you pound/use your feet the neuroma just keep growing.

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