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Darren, I did have it in my right foot. It felt like bone gringing on bone in my foot and was incredibly painful after about 1.5 miles on every run. Resting did not help at all for me, and I ended up having steroid injections into it. The first injection lasted 2 months so I could keep training, but then the second one only lasted 2 weeks so therefore surgery was the only option.
I was entered in Brighton marathon last year and my consultant and GP understood what it meant to me to run, so when the steroid injections failed they hatched a plan! What happened then was that apparently normal painkillers do not touch nerve pain, a low dose of anti-depressants numb the nerve receptors in the brain so I went onto very low dose, starting 3 weeks before the marathon and then as it was such a low dose I went cold-turkey on the day.
This then resulted in the fact I could go ahead with the Brighton Marathon with no pain and then I had the operation on my foot on the Friday following the Marathon.
So....there are ways of managing the pain, and completing the marathon but for me there was no way to reverse the neuroma so surgery was the only answer.
Oh and also the surgery they did was a new one where the nerve was left in but the tendons/ligaments cut and spacers put in, it has been very sucessful and means I keep the feeling in the toes.
I have a huge history with MN. I have (had) two in each foot. I have had nearly every conceivable treatment (orthotics, metatarsal pads, cortisone, alcohol sclerosing, shockwave therapy, cryosurgery, traditional surgery, and lastly, removal of the stump neuromas and implantation of the nerve ending into the arch muscle). The reason I had to have the final surgery was because due to the non-sense practices of a podiatrist (many in the US do it the same way which is wrong) who did the traditional surgery where he simply cut out the neruomas and left the nerve ending to find it's own home left me with new stump neuromas, which are worse than the original condition. When they just cut out the neuroma, the nerve ending will try to grow back to where it was, and when it does, it usually meets scar tissue. It will try to grow into that scar tissue, but it can't, this a stump is developed. The last surgeon (a peripheral nerve surgeon) had to remove the stumps and implant the nerve endings into muscle, so they would stop growing.
Betty is correct in recommending MN decompression (that's the name of the procedure here in the US she had done), and that's usually what the peripheral nerve surgeon would have done for me, except that I had stumps that we had to deal with. So, if you have to have surgery, find a doctor who is well-versed in decompression of the nerve. This saves the nerve, but it cuts the tendon. Both seem drastic, but I would opt for keeping the nerve and cutting the tendon and avoid all the pain that comes from nerve damage/amputation and the phantom pains (which are very real) too.
Good luck to you. If you would like to find out more about the various options and treatments for MN, please visit www.MortonsNeuromaTalk.com. -TJ
my mrs has had a pain on the underside of her middle toe for 2-3 mths and has just been diagnosed with MN. She had an injection into it last week but as yet it appears to have given her little or no improvement. Her Doc said they would try 2-3 more over coming weeks and may have to look into surgery if these don't work. She's pretty worried as most things you read suggest surgery is hit and miss at best.
Betty - not sure you'll see this message but if you do, where did you get your surgery done? I'm looking for somewhere that does that new kind of surgery where the tendon is cut rather than the nerve. Thanks!
Hi Ade, aha, I wa notified of a reply! Okay now my surgeon wa Magnus McLaren at the Spire in Havant. Fantastic surgeon and it helps that his son is an ultra runner so he absolutely understands the need to run.
Hi Ade, well it was the surgeon who recommended it as of course when you have the nerve removed that's it...kaput...for any feeling in those toes, and when you run (and even generally) you really benefit from feeling.
The surgery *is* more involved and skilled to get the spaces absolutely right, and I hate to say it but if you have on NHS then - quite naturally - they need to look at cost Vs benefit and the more involved the surgery, the costlier.
I didn;t ask how many more he had done but he certainly knew what he was doing. It was 2012 I had the surgery and have been pain free since - though I am also more aware so don;t wear vertiginous heels, or compression socks, or anything that would irritate it anymore. Very occasionally (after marathon distance) I can start to "feel" an ache now, but it goes after a while and may be more linked to me being more aware of my feet.
Before the op I had the pain for about 6 months and was like walking on glass which started occasionally but then developed to almost permanently, if I turned fast, or got the camber wrong it took my breath away and my knees just crumpled with the pain. I ran in tears an awful lot!
Feel free to ask whatever Qs you have - I am also at "firstname.lastname@example.org" if easier?
I was like Betty - had the op but now absolutely fine. Managed to have it done on the NHS and persuaded them to avoid the main running season!