Morton's Neuroma

Discussion Topic

Return to Forum List

This thread has been locked

Messages 1 - 19 of total 19 in this topic

Mtnmun

Trad climber

Top of the Mountain Mun

Topic Author's Original Post - Nov 11, 2007 - 11:27pm PT

Has anyone had any experience treating this? Acupuncture, surgery, herbs, foot pads?

The pain, especially when mountain biking, is getting unbearable.

http://www.pcopco.com/neuromas.html

matisse

climber

Nov 11, 2007 - 11:50pm PT

foot pads can work great. especially for biking, they sometimes are a bit fussy to get in the correct position, (behind the metatarsal heads of the two metatarsals that the neuroma is between) but it beats the hell out of surgery. use them on the insole of your cycling shoe. its one of those fairly instant feedback things..you mess with them til they feel ok and then try em a couple of days to see if it works

Mike Bolte

Trad climber

Planet Earth

Nov 12, 2007 - 12:10am PT

I was thinking I'd have to give up climbing (or at least climbing shoes) a few years back the pain was getting so bad. But, I started buying my shoes 1/2 size (Euro sizes) larger and using these inexpensive gel pads in the front of my shoes. It helps alot. Read a bunch of stuff on line and concluded surgery is a little more risky than average for this particularly problem.

Crimpergirl

Social climber

St. Looney

Nov 12, 2007 - 12:56am PT

bigger shoes and alleve has been magic for me. have one on my ankle too. got a corticosteroid shot in it. most painful moment of my life. never again!

Crimpergirl

Social climber

St. Looney

Nov 12, 2007 - 02:43am PT

I'm not a medical doctor like Matisse, but I can tell you what my doctor told me.

Getting it cut out is an option. There will be superficial numbness but you won't be a foot dragger. having some numbness may actually be useful for crack climbing too. :) (the doctor didn't say that part).

Problem with getting them cut out is that it is thought that neuromas are caused by trauma (e.g., really tight shoes). So, one can get another neuroma on the nerve stump and be back to square one even with the surgery.

I got a corticosteroid shot in the one on my ankle to shrink/desensitize it. It was so exquisitely un-be-freakingly painful that I couldn't wear socks and barely hitting it brought tears to my eyes and speechlessness. The shot did shrink it, and it is far less sensitive, but holy freaking mother of all - it hurt like nothing i've ever felt. if they ever wanted to do that to me again, I've have to be totally knocked out.

matisse

climber

Nov 12, 2007 - 03:24am PT

Sure you can just get it chopped out, but why have surgery when you don't need to?
Risks of anaesthesia, infection, painful scar etc. plus the problem may reoccur like crimpie says. the recovery will put you out of action for a while as well.

treatment (in order):
padding/orththotics/ (personally I'd spend a LOT of time on this option)
pills (tumeric?)/accupuncture
corticosteriod injection-the nerve is fat, so the idea is you shrink it and it won't get pinched so much. like crimpie said injections in the foot tend to hurt like a S.O.B.
last resort: surgery

In my experience and I've treated a bunch of these a little well placed padding works wonders, but it's got to be in the right place.

Jude said most of the problem was in his cycling shoes, an ideal place to modify the insole (doing it to the everyday foot wear would be a good idea too). I imagine you could also modify a climbing shoe without too much trouble, but often if you just get most of the bases covered you get things going in the right direction and won't need to do it for every shoe.

I always liked the diagnosis of an established mortons neuroma...classic history, tenderness between the metatarsals, and then when you compress the foot, you can actually feel this little click as the neuroma flips out...I can't believe they suggest an MRI to make the diagnosis.

HuecoRat

Trad climber

Nov 12, 2007 - 09:07am PT

I had this condition for about 8 years, and last year I had to do something about it. We tried injections and ultrasound, but had to resort to surgery. The procedure is very straightforward, and resulted in a pain-free foot! I had a minor post-op infection and missed most of the ice season, but was bouldering pain free in the spring, and have had a great summer. Give me a shout if you need more details. My neuroma was an inch in diameter (doctor's were impressed! I guess size does matter!)
Brian

captain chaos

climber

Nov 12, 2007 - 09:59am PT

I've been living with this headache or should I say footache since 93. I got a corticosteroid shot and it worked, but I have to agree with Crimpe, it hurt like hell and I would have second thoughts about doing it again, think big old needle straight into the ball of your foot into the problem area, and then think pain, nasty pain ... it was a not the best experience. Anyway, it seemed to hold up and I never got one of those shots again. What I have resorted too which probably will seem crude to all of you is I always cut a circle of my insole out where the contact point is, thus no pressure on that part of my foot. I'm sure all doctors would gasp at my procedure, but you know what, it works and I haven't had to get another one of those nasty painful shots again. For my ski boots I have a custom made footbed which seems to do the trick. Anyway, good luck with what ever route you decide to take, and if you need immediate relief, try cutting the insole of your shoe out where the contact point is, because it works... if the insole is think enough anyway, as its obvious it wouldn't help much if the insole was paper thin.

Murf

climber

Nov 12, 2007 - 10:51am PT

I actually take one of the gel toe separators for hammer toe and place between ring and pointer toe. The hammer toe ones are quite a bit larger than some of the other gel separators, but they work for me.

Crimpergirl

Social climber

St. Looney

Nov 12, 2007 - 11:01am PT

It was like a scene from the exorcist when I got the shot. I think I turned colors, spewed horrendous profanities, screams, profuse sweating, saying really mean things to the doctor, involuntary kicking (lucky he didn't lose his teeth). The syringe went flying, needle bent. Horror show.

Because of the demon-induced involuntary thrashing on my part, he had to stick me THREE times to get all the medicine in. Unbelievably painful.

I got the shot in my ankle along the same nerve that goes to the foot where the neuroma is more common. Not sure the location made it hurt worse, but I honestly can't imagine anything hurting worse than it did.

And he told me that it wouldn't hurt. What a liar!

Mtnmun

Trad climber

Top of the Mountain Mun

Topic Author's Reply - Nov 12, 2007 - 11:35am PT

Thanks everyone! After an hour of riding the foot feels like there is a hot knife stuck in my foot.

I have tried the hole in the foot bed insert. I'm buying the jell pads and am going to see what they have for foot cushions.

I will try to avoid the shot. OUCH!

Thanks again.

Jude

scuffy b

climber

The deck above the 5

Nov 12, 2007 - 12:34pm PT

On the cycling shoe insoleissue:

The pad suggested by Matisse is essential.
It may be useful or necessary to thin the insole lateral and
distal to the neuroma.
The pad is to spread the heads of the metatarsals, but there
must be some room available for the spread. A little material
removal can go a long way.
I've had the problem since 1972.
Fortunately for me, it comes and goes.

captain chaos

climber

Nov 12, 2007 - 01:09pm PT

Crimpe your description of your shot is hilarious... (sorry, I have a twisted sense of humor) I don't know why these guys don't give you a shot of Novocain in the area first, it seems to me that it would make the whole thing much more reasonable. Maybe the current treatment was suggested by herr gute Doctor Mengele, as its definitely torturous.

Karl Baba

Trad climber

Yosemite, Ca

Feb 7, 2008 - 10:21pm PT

Sorry to bump this thread again but Nobody mentioned one of the best treatments which is a series of Alcohol injections at the site.

http://www.biomech.com/db_area/archives/2002/0204.painmana.bio.shtml

http://www.nbwebexpress.com/achieve_more/neuroma/neuroma_print.asp

Injection Therapy: The two common agents used in injection therapy of neuroma are corticosteroid/local anesthetic and alcohol sclerosing agent. Corticosteroid is injected around the nerve to decrease the inflammation and reduce fibrosis or scaring. Greenfield found that 30% of patients undergoing corticosteroid/local anesthetic therapy had complete relief of symptoms and 50% had partial relief [4]. Alcohol sclerosing agent is a dilute mixture that includes a small percent of alcohol and a numbing medication. The alcohol is injected around the nerve in hopes of reducing its size. The therapy involves a series of 3-8 injections with 5-10 days between injections. Dockery found an 89% success rate using this method of injection therapy [5].

Peace

Karl

SteveW

Trad climber

Denver, CO

Feb 8, 2008 - 08:42am PT

Karl
Did they use Wild Turkey or a good Scotch?
Sorry, I couldn't resist. . . my bad.

Chip

Trad climber

Wilmington, DE

Feb 8, 2008 - 09:09am PT

Been treating these many years, including my own experience. In the right hands the injection really is minimally uncomfortable. Yes, I gave myself one. I haven't had to remove one in a couple years since we have been using the sclerosing injections. Of course, everyone is different and you never know, but shoe changes, pads and orthotics are the stuff.

drbj

climber

Mar 3, 2009 - 09:39am PT

I'm Dr Jarrett, I have been a podiatric surgeon for almost 30 years. I closed my surgical practice 6 years ago to persue full time biomechanical research and my love of mt biking.

I mt bike daily in Moab Utah. 4 years ago I developed a neuroma as I was training for the Intermountain cup series. My training milage was so excessive that inspite of the fact that I wore a traditional orthotic device during all weight bearing activities, as well as when I would ride, the pain intensified.

As a foot surgeon with 20 plus years of experience, neuroma surgery was not an option. Alcohol injections are so unpredictable and ineffective that I would never consider that form of treatment. Metatarsal pads were somewhat helpful but the pain was still disabeling. Cortizone injections were sometimes helpful and could help me get through a race, but the benefits were temporary.

To make a long painfull story more tollerable, I invented a 12 gram wedge that is placed between the contact point of the foot with the pedal. Problem resolved.

Now for 25 dollars you can get the same help. It is called a Propulsive Stage Theta (PST)wedge, you can order it at www.pcopco.com. and it will stop the pain of Morton's Neuroma.

So much for the Kunta Kintai (sp) School of medicine...