What has helped with your Morton’s Neuroma?
February 29, 2024 7:22 PM Subscribe
Recently diagnosed and looking for any advice on treating and managing MN, from acupuncture and anti-inflammatory diets to zero-drop shoes, injections and surgery. Please hope me!
In a nutshell: I have a massive MN in my left foot and a slightly smaller one in my right foot. My podiatrist has given me metatarsal pads and is recommending injections. My doctor (GP/primary care physician)
has sent me for blood tests for inflammation markers, and referred me straight to an orthopaedic surgeon (who I can’t get in to for 5 weeks anyway). Meanwhile, I’m getting increasingly depressed at not being able to enjoy walking the dog, hiking or cycling.
I’m lost amongst all the online information. If anyone has suffered this horrible, painful condition and can tell me what’s helped them, I would be hugely grateful. Assume I have unlimited time and money to throw at this. Thanks in advance.
In a nutshell: I have a massive MN in my left foot and a slightly smaller one in my right foot. My podiatrist has given me metatarsal pads and is recommending injections. My doctor (GP/primary care physician)
has sent me for blood tests for inflammation markers, and referred me straight to an orthopaedic surgeon (who I can’t get in to for 5 weeks anyway). Meanwhile, I’m getting increasingly depressed at not being able to enjoy walking the dog, hiking or cycling.
I’m lost amongst all the online information. If anyone has suffered this horrible, painful condition and can tell me what’s helped them, I would be hugely grateful. Assume I have unlimited time and money to throw at this. Thanks in advance.
Ugh, Morton's is the worst. I fought it for several years with shoes, insert pads and steroids until I finally gave up. My doc refused to do alcohol injection at all, saying it would be either useless or damaging, but seldom resolved the issue. Eventually I had surgery that finally resolved it. My surgery was dorsal removal of the neuroma with an intermetatarsal ligament release. I was in a boot and on a scooter for weeks and weeks, although it wasn't as painful afterwards during healing as I was told it would be. My neuroma was fairly large, and the surgeon said he did a lot of "digging around" which made the recovery longer. Apparently, the neuroma is easier to access from the bottom (plantar) surface of the foot, but the scar can give major problems afterwards, so that type of surgery is very seldom done unless dorsal surgery fails. For about seven months after my operation, I was still a bit sore and gimpy after a long day on my feet or major exercise hiking or riding my horse at a trot. My shoes need to be sized wide enough to fit that foot, and they are hella wide now, between the surgery and my feet spreading as I have aged.
This was nearly 18 years ago, and they are not recommending surgery as frequently as they used to. There are several options for ablations--cryogenic, radio frequency, and neurolytic. From what I understand the neurolytic ablation is not an alcohol sclerosing injection done by many podiatrists such that my surgeon refused to do.
My brother now has a smallish neuroma that he's managing by wide toebox shoes. He's tried Kuru and Hoka, and he prefers the Hoka (but I think it's the wild colors) He applies ice by freezing a water bottle and rolling with his foot and says a TENS massage helps. He also swears by intrametatarsal space release and Aspercreme maximum relief aspirin gel.
If your large neuroma is as painful as mine was, I don't doubt you want it GONE! Research your options well, as I had a friend who had cryogenic ablation and was happy with it. Much faster, less invasive, and short healing time. You might be able to get by with your smaller neuroma by using my brother's tricks for a while.
Good luck!
posted by BlueHorse at 9:31 PM on February 29 [2 favorites]
This was nearly 18 years ago, and they are not recommending surgery as frequently as they used to. There are several options for ablations--cryogenic, radio frequency, and neurolytic. From what I understand the neurolytic ablation is not an alcohol sclerosing injection done by many podiatrists such that my surgeon refused to do.
My brother now has a smallish neuroma that he's managing by wide toebox shoes. He's tried Kuru and Hoka, and he prefers the Hoka (but I think it's the wild colors) He applies ice by freezing a water bottle and rolling with his foot and says a TENS massage helps. He also swears by intrametatarsal space release and Aspercreme maximum relief aspirin gel.
If your large neuroma is as painful as mine was, I don't doubt you want it GONE! Research your options well, as I had a friend who had cryogenic ablation and was happy with it. Much faster, less invasive, and short healing time. You might be able to get by with your smaller neuroma by using my brother's tricks for a while.
Good luck!
posted by BlueHorse at 9:31 PM on February 29 [2 favorites]
I got some HOKA recovery sandals for wearing around the house (at the suggestion of my podiatrist), and they're pretty great. I hadn't realized how much pounding I was doing to my feet, and how big a difference there is between these and, e.g., regular flip flops. They're 60 USD usually, but some off-color out-of-season versions at REI were just $30.
posted by pjenks at 5:00 AM on March 1 [1 favorite]
posted by pjenks at 5:00 AM on March 1 [1 favorite]
Best answer: I’m sorry you are going through this. Foot pain is so hard to live with, especially when it means you can’t get your usual physical activity in. I was very fortunate - mine was smallish and a singe steroid shot calmed it down.
Be kind to yourself! Watch out for those online pits of despair, ok?
posted by hilaryjade at 6:04 AM on March 1 [1 favorite]
Be kind to yourself! Watch out for those online pits of despair, ok?
posted by hilaryjade at 6:04 AM on March 1 [1 favorite]
Check out Topo Athletic shoes, while you're at it -- wide toebox, but still have arch support (unlike Altras, say).
These are the shoes I ended up using to mitigate an MN-like metatarsalgia.
posted by peachfiber at 6:09 AM on March 1 [1 favorite]
These are the shoes I ended up using to mitigate an MN-like metatarsalgia.
posted by peachfiber at 6:09 AM on March 1 [1 favorite]
In my case, surgery was the only option that made any difference. Two neuromas in my left foot. It's been almost three years since the surgery and I have not developed any new ones. The two toes near the incisions still have not gained full feeling, but I am painfree.
Foot exercises and icing helped some in the short term. All the metatarsal pads, shoe inserts, etc. made no difference for me. I have no more heeled or pointy toes shoes (no great loss IMO). That nerve pain is the WORST. Sorry you're suffering.
posted by XtineHutch at 6:22 AM on March 1 [1 favorite]
Foot exercises and icing helped some in the short term. All the metatarsal pads, shoe inserts, etc. made no difference for me. I have no more heeled or pointy toes shoes (no great loss IMO). That nerve pain is the WORST. Sorry you're suffering.
posted by XtineHutch at 6:22 AM on March 1 [1 favorite]
Best answer: I feel like there's just a ton of personal variation on this, and also variation within each person overtime!
I have tried lots of things and what has become clear to me is that what was best at one stage is not best (and could be bad) at other stages. In particular, the metatarsal pads were very helpful when it was so bad I could hardly walk, but as I healed past that, they began to cause as much discomfort as they were relieving, so I haven't used them in a long time. It's a bit like a crutch: very helpful to help you get around, but most people don't plan on using them forever.
I have lots of different shoes and slippers and what works best changes on a scale of a few months or so. So e.g. Adissage soccer slippers were good for a while but then I switched to classic cork Birkenstocks for a while. Now I'm mixing them both. Keen shoes and sandals have worked well for me. Just keep buying shoes and slippers and pay attention: what seems good for a few hours or days may not be good in the long run!
A big help for me that nobody mentioned: toe-spreading socks. Similar to the idea of releasing space between the metatarsals in the video above, devices like these just slowly spread your feet overnight. I saw good improvement after a few weeks of using mine, and now use them periodically but not most nights.
Also, minimizing time on my feet never really helped much, and now that I've made progress and can walk for a few miles without much discomfort, I find that doing *more* walking and jogging per week is better than less.
The steroid injections helped a bit, but not that much for me. Here is a scholarly overview of many treatments for Morton's Neuroma.
The rest of my suggestions are things that I think have given me some benefit and are harmless to try:
Hot foot baths with epsom salts have helped a bit, but I seldom make the time to do it.
There is some evidence B12 may help with neuroma and neuralgia, as long as you don't take wild amounts it can't hurt to try for a bit.
I also take turmeric daily as a general anti-inflammatory. Again, some modern scientific evidence of help, no harm, and inexpensive.
Any/all topical treatments. Things like menthol and capsaicin ointments sort of dull the pain, and may aid healing by increasing blood flow. I also like Emu Oil. All of these have the benefit of getting you to rub your feet more.
Finally, I do use roller balls and a sort of tube-shaped foot roller. Again I advise trying several, they are cheap. I have not yet gotten in to foot-massage machines but I may.
Hang in there, you can probably get a lot better!
posted by SaltySalticid at 7:36 AM on March 1 [2 favorites]
I have tried lots of things and what has become clear to me is that what was best at one stage is not best (and could be bad) at other stages. In particular, the metatarsal pads were very helpful when it was so bad I could hardly walk, but as I healed past that, they began to cause as much discomfort as they were relieving, so I haven't used them in a long time. It's a bit like a crutch: very helpful to help you get around, but most people don't plan on using them forever.
I have lots of different shoes and slippers and what works best changes on a scale of a few months or so. So e.g. Adissage soccer slippers were good for a while but then I switched to classic cork Birkenstocks for a while. Now I'm mixing them both. Keen shoes and sandals have worked well for me. Just keep buying shoes and slippers and pay attention: what seems good for a few hours or days may not be good in the long run!
A big help for me that nobody mentioned: toe-spreading socks. Similar to the idea of releasing space between the metatarsals in the video above, devices like these just slowly spread your feet overnight. I saw good improvement after a few weeks of using mine, and now use them periodically but not most nights.
Also, minimizing time on my feet never really helped much, and now that I've made progress and can walk for a few miles without much discomfort, I find that doing *more* walking and jogging per week is better than less.
The steroid injections helped a bit, but not that much for me. Here is a scholarly overview of many treatments for Morton's Neuroma.
The rest of my suggestions are things that I think have given me some benefit and are harmless to try:
Hot foot baths with epsom salts have helped a bit, but I seldom make the time to do it.
There is some evidence B12 may help with neuroma and neuralgia, as long as you don't take wild amounts it can't hurt to try for a bit.
I also take turmeric daily as a general anti-inflammatory. Again, some modern scientific evidence of help, no harm, and inexpensive.
Any/all topical treatments. Things like menthol and capsaicin ointments sort of dull the pain, and may aid healing by increasing blood flow. I also like Emu Oil. All of these have the benefit of getting you to rub your feet more.
Finally, I do use roller balls and a sort of tube-shaped foot roller. Again I advise trying several, they are cheap. I have not yet gotten in to foot-massage machines but I may.
Hang in there, you can probably get a lot better!
posted by SaltySalticid at 7:36 AM on March 1 [2 favorites]
Forgot to add: this site has some additional toe spreaders and you can also shop for their shoes that are suggested for neuroma.
posted by SaltySalticid at 7:47 AM on March 1 [1 favorite]
posted by SaltySalticid at 7:47 AM on March 1 [1 favorite]
A friend swears by their custom ($pendy) orthotics.
posted by Iris Gambol at 7:56 AM on March 1 [1 favorite]
posted by Iris Gambol at 7:56 AM on March 1 [1 favorite]
A lidocaine injection helped me, and it did not come back.
I stopped wearing “minimal” soles shoes as well.
There may be a genetic component here, my parents have had MN too.
posted by bug138 at 10:30 AM on March 1 [1 favorite]
I stopped wearing “minimal” soles shoes as well.
There may be a genetic component here, my parents have had MN too.
posted by bug138 at 10:30 AM on March 1 [1 favorite]
Diagnosed about 20 years ago... Custom orthotics with metatarsal cushions and acupuncture whenever it flares up have done the trick for me. I did try cortisone shots at the very beginning but they didn't seem to help much.
posted by kbuxton at 12:38 PM on March 1 [1 favorite]
posted by kbuxton at 12:38 PM on March 1 [1 favorite]
I had two big ones on the right, either side of the third toe. I tried everything but surgery did it in the end. I spent two weeks on the sofa with my foot elevated above my heart then another six weeks on crutches. It's now been about 10 years and absolutely fine, the toe is generally numb but I don't have any loss of function or pain.
I have a much smaller one on the left. I had an MRI-guided cortisol injection about eight years ago and only get the occasional painful twinge after walking very far, certainly nothing debilitating.
Best wishes, I do hope you find a treatment that works for you soon!
posted by goo at 3:03 PM on March 1 [2 favorites]
I have a much smaller one on the left. I had an MRI-guided cortisol injection about eight years ago and only get the occasional painful twinge after walking very far, certainly nothing debilitating.
Best wishes, I do hope you find a treatment that works for you soon!
posted by goo at 3:03 PM on March 1 [2 favorites]
Missed the edit window - I meant cortisone above, not cortisol! Take care.
posted by goo at 3:27 PM on March 1 [2 favorites]
posted by goo at 3:27 PM on March 1 [2 favorites]
Response by poster: Thank you so much for all your thoughts. I’ve marked a couple as favourites, but really they are all ‘best answer’. Your support is much appreciated!
posted by Salamander at 7:29 PM on March 1
posted by Salamander at 7:29 PM on March 1
As several mentioned above, there are various/ combination treatments for MN.
My affected part is my next to baby toe/right foot ("This little piggy had none.") My symptom was a breathtaking shooting pain from that toe up the back of my leg. I'd have about 30 minutes of prickly zappy toe pain before the BIG pain would start.
7ish years ago I went to new doc and she gave me a 3 ingredient injection into the neuroma spot. A bit of lidocaine, an anti-inflammatory, and a steroid. Just prior to the shot she asked me to not kick her in the face. Yes, it hurt, very briefly. I have since had 2 more shots over the course of almost 7 years. She said that at a certain point that toe will become permanently numb. I'm ok with that. Will probably be going in for another shot in the future. If I wear certain shoes, toe wakes up and is unhappy. I've gotten rid of nearly all the shoes that hurt, but have a few that I still love even though they are not good for me...
Best I can suggest is let your doctor know what your level of activity is, what's most important to you as far as mobility, and what risks are attached to various treatment/ surgeries. This condition seems to have more choices as to how you can deal with it than a lot of human afflictions. I hope you can find a good solution!
posted by LaBellaStella at 9:05 AM on March 2
My affected part is my next to baby toe/right foot ("This little piggy had none.") My symptom was a breathtaking shooting pain from that toe up the back of my leg. I'd have about 30 minutes of prickly zappy toe pain before the BIG pain would start.
7ish years ago I went to new doc and she gave me a 3 ingredient injection into the neuroma spot. A bit of lidocaine, an anti-inflammatory, and a steroid. Just prior to the shot she asked me to not kick her in the face. Yes, it hurt, very briefly. I have since had 2 more shots over the course of almost 7 years. She said that at a certain point that toe will become permanently numb. I'm ok with that. Will probably be going in for another shot in the future. If I wear certain shoes, toe wakes up and is unhappy. I've gotten rid of nearly all the shoes that hurt, but have a few that I still love even though they are not good for me...
Best I can suggest is let your doctor know what your level of activity is, what's most important to you as far as mobility, and what risks are attached to various treatment/ surgeries. This condition seems to have more choices as to how you can deal with it than a lot of human afflictions. I hope you can find a good solution!
posted by LaBellaStella at 9:05 AM on March 2
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Because you are thinking about surgery, have your doctors said anything about less invasive but still neuroma-destructive options like alcohol neurolysis injections or RF ablation? I know these options exist, but don't know how they are regarded among doctors that do foot/ankle procedures; the recovery time at least should be less than surgery.
posted by Inspector.Gadget at 7:46 PM on February 29 [1 favorite]