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Old 07-23-2005, 07:17 AM   #1
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Neuroma between 2nd and 3rd toes--Really need advice!

I just read a previous poster saying that rarely is there a neuroma between the second and third space. I'm confused by this, as I have been diagnosed with one---confirmed by MRI as a 6mm neuroma. I certianly have the symtoms but am also experiencing achey pain across the forefoot and into my third toe. My new doc is concerned about joint trauma in the third toe joint or inflammation and gave me a numbing agent in the joint (not in the neuroma) to try and determine if my pain is from the neuroma or from the joint. I was told to walk a lot after the injection (it lasted about 4 hours). I did get some relief from the achey pain across forefoot but when I put on a flat (not cushioned) dress shoe with a low heel and walked I could feel the electical sensation from the neuroma. So I'm thinking I have both problems, and after doing some reading, maybe metatarsalgia, which I think is just a fancy word word for inflammation of the region around the metatarsals. My symptoms seem to fit the description. And this makes sense because after having two double bunionectomies in two years, I certainly was favoring my big toe area and probably putting undue weight/pressure over my smaller toes during the healing process. Plus my bunion was more severe in my left foot and that's where my current problem is. But treatment for this seems very vague...

So what to do? New doc (have only seem him once but seems very good and is very well regarded) is not one to rush into surgery, which is good, but I'm also afraid I'll never get relief. He suggested some padding under my foot as a possible treatment, which just seems like under treating to me. I've already been through cortizone shots and alcohol treatmetns by the way (with previous doc)---didn't work and frankly, I'm worse now (though have no idea if that's why).

Just so frustrated because soon I'll need to be out on the road at conferences and dressed up. I buy aerosoles and other shoes meant to provide plenty of support but I still have difficulty being on my feet and in my job, I often have to be. In addition, I am expected to look relatively fashionable (work in marketing) so I can't show up in clunky orthopedic shoes!! Hate to sound vain but it's sort of the reality of my job.

I'd very much appreciate any and all feedback.

Lesley

 
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Old 07-23-2005, 08:52 AM   #2
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Re: Neuroma between 2nd and 3rd toes--Really need advice!

Mediamom--I've had neuroma surgery on both feet. The first was in 98 and I had two, one between toes 2 and 3 and the other between toes 3 and 4. My doc said 3/4 is the most common followed by 2/3 which doesn't agree with a previous poster. I suffered for 10 years doing the same things you did with my first foot and am so glad I finally had the surgery. Everything has been fine and no recurrences. The second surgery was 4/4/05 along with a bunionectomy and hammertoe.

The neuroma surgery is soft tissue surgery so the recovery is less than bunions/hammertoes and other bone procedures. I was put in a surgical shoe right away but it was painful to get around for a while but quite frankly wasn't any more painful than living with the neuroma.

Find a good doc ask about his stats on recurrences, etc. Some people on this board don't recommend the surgery but for me it worked out great.

Linda

 
Old 07-23-2005, 09:11 AM   #3
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Re: Neuroma between 2nd and 3rd toes--Really need advice!

I recommend it highly and second the find a good doc, ask about stats, references, etc. I ALWAYS recommend if you live in a city with a professional sports team that you find out who they use for this. He's the one you want! I guarantee you that they don't let million dollar player sget cut on by hacks...good luck! That' what I did and couln't be happier with the results.

 
Old 07-23-2005, 12:50 PM   #4
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Re: Neuroma between 2nd and 3rd toes--Really need advice!

Thanks for the input. My doc told me he does about one a month and that he honestly has not had any stump neuroma complications among his patients---though i know the average is more like 15-20%. Does 12 a year sound like enough? This guy does a ton of surgeries and is head of a podiatry residency at University of Pennsylvania's podiatry program. Very good credentials. I've been through quite a few podiatrists and he is definitely one who has inspired confidence. You know that feeling when you just believe they know what they're doing. And he is not anxious to jump into surgery. I guess my major concern is how much of my pain is the neuroma and how much is some kind of joint inflammation.

Anyway, thanks for the feedback and glad you've had good success with your surgeries.

 
Old 07-25-2005, 07:10 PM   #5
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Re: Neuroma between 2nd and 3rd toes--Really need advice!

If the marcaine was injected into the joint near the neuroma, it is quite likely that it "scrolled over" to the neuroma nerve providing you with some temporary pain relief. Perhaps you could ask him to numb the neuroma area (between the 2 met heads) and see if that resolves all your pain. If it does, then likely the neurectomy will too, permanently.
I wish you the best of luck!

 
Old 07-25-2005, 08:00 PM   #6
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Re: Neuroma between 2nd and 3rd toes--Really need advice!

OK, obviously you are in a town with a pro sports team! I'd go to their doc for a second opinion and then make your decision. What great resources you have! I used a sports medicine orthopaedic doc for mine but he's the best in the SE and one of he best in the country...and he said he did about 10 a month....he was with one of the top sports medicine groups in the country and the signed jerseys in the exam rooms are from tons of well known sports figures. I think I did my research and I am very pleased with the results. Good luck!

 
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