WHERE DOES IT HURT ?
A neuroma in the foot is a benign growth that occurs when the nerves in the ball of the foot are pinched and inflamed. It is most commonly found between the third and fourth or second and third toes and adjacent web spaces of the foot.
Symptoms may include pain, burning, tingling or numbness between the toes and on the ball of the foot associated with standing for long periods of time or increased activities.
Take a look at our videos below that include the surgical removal, patient testimonial experience with injecting the 'Sclerosing agent' in the clinic, as well as custom molded orthotics to keep the pressure off the ball of the foot.
The neuroma can be removed with minimal effort and numbness or loss of sensation is limited to the involved web space. The incision is made from the top of the foot (average 1.5cm to 3/4 inch) and sutures are removed at 2 weeks. The procedure is performed at an outpatient facility under sedation.
Partial weight bearing is allowed after 48 to 72 hours of non weight bearing.
Anti-inflammatory medication can help with the chronic pain, but are not much help with the acute pain
There are an array of over the counter orthotic pads that can be placed to help relieve the pain.
Temporary arch supports or custom molded orthotics can minimize the pressure or correct the foot position causing the pressure. These devices are good solution for long term treatment with or without surgical intervention.
CORTISONE: This powerful anti-inflammatory mixed with a local anesthetic is injected around the painful neuroma to help shrink the swollen tissue and give both temporary relief and help diagnose the problem. The number of injections are limited, but in most cases this treatment combined with pressure off devices like custom molded orthotics is all that is needed for relief and long term care.
Sclerosing Agent: Medical grade alcohol mixed with a local anesthetic in the correct proportions is a safe, non surgical and effective treatment for shrinking the painful neuroma when cortisone injections have failed.
“Sclerosing” translates to chemical scaring - targeted injury that permanently shrinks the sensory nerve branch. The number of injections vary and are given until sufficient relief is achieved. Custom molded orthotics are also combined with this treatment.
MORE INFORMATION ON NEUROMA
CAUTION GRAPHIC CONTENT: This is an actual surgery performed on a patient
This patient came into the office for concerns about pain and the positioning of her toes. The pain was diagnosed as a neuroma which responded to cortisone injections initially. The toe 'splaying' or spreading was actually a dislocation and Plantir plate tear. This was from an accident although this can happen with excessive force during exercise, sports, or spontaneously.
The surgery went well and this is her 8 week post operative visit. Many thanks to the representatives at www.Arthrex.com who provided the equipment from their CPR system and procedure modification we used for this unique problem.
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These are links to more information on the subject, not intended to imply an endorsement.
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