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Neuroma but no MRI show...yet surgery??

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Old 11-26-2011, 08:56 PM   #1
Join Date: Nov 2011
Location: Palo Alto, CA
Posts: 2
neuromaguy HB User
Neuroma but no MRI show...yet surgery??


About 3 months ago I stubbed my toe (pinky and 4th toe) against the foot of my bed, and ever since then there's been this "cracking" in the ball of my foot (near where metatarsals meet toes) that I noticed whenever I walk. After walking long enough, it gets very painful.

I saw a podiatrist who said I have a neuroma. But I really don't have the common neuroma symptoms, it's just this "cracking" and I can force it by walking on my toes/balls of feet. He gave me a cortisone shot which had zero effect.

I also don't seem to have any symptoms when barefoot, but wearing shoes is terrible unless I stick a metatarsal pad in them. And ironically only id I put the metatarsal pad in the "wrong" place -- further up than recommended.

I saw a second podiatrist who said it was either bursitis or neuroma. He ordered an MRI which showed nothing. He said it's probably a neuroma so I should get surgery.

But I am scared to death of getting surgery if it turns out there's NO neuroma and this just excises a nerve without solving any problems...

I'd also like to try physical therapy but the 2nd doctor said it almost never works and he'd recommend the surgery straight away.

Would really appreciate any help/advice...I am ONLY wearing extra wide sneakers (Asics). I am also trying some Pediflex toe cushions/spacers, but not sure if that is a good idea or bad. The metatarsal pad helps but I worry I might be hurting my foot with it given that it's pressing on the metatarsal itself.


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Old 11-28-2011, 08:40 AM   #2
Join Date: Dec 2010
Location: VA, USA
Posts: 61
killneuroma HB User
Re: Neuroma but no MRI show...yet surgery??

Did you take the MRI with 3T or with contrast? You should take a ultrasound test for neuroma. I am not a doctor but most of neuroma is diagonosed by ultrasound test. Some people said MRI is the most accurate tool but it cuts the picture by 3mm. If neuroma is very big, maybe more than 5 mm, it should show in the MRI but if it is less than 5 mm, MRI may not show neuroma. My ultrasound test said I have neuroma between second and third, size of 12mm and 15mm. But MRI does not show any, MRI said I have very small capsular tear. I do not have typical neuroma pain. I can not stand or wallk barefoot specially hard floor. I would not do any surgery nor any injection. Those injections could cause a fat pad atrophy. Some podiatrists say alcohol injections are not cause fat pad atrophy and some say they do.
There are several treatment for neuroma, cryosurgery, radio frequency ablation and alcohol injections. I had terrible experience with alcohol injections, I stoped 2 injections, first podiatrist even injected wrong interspaced. These injections made my feet worst.
I would recommend to you to take a ultrasound test and see what is going on.
Neuroma surgery is not urgent surgery, it is causing you pain but you could wait to find what is real problem because foot problems, symptoms are very similar. Find a doctor or podiatrist who is very good. From my experience, many podiatrists want to do injections, I think they can charge alot of money, but those injections could lead to permanent damage to you foot. Be very careful if you would want to do any injection treatment.

Old 11-28-2011, 09:15 AM   #3
Join Date: Apr 2005
Location: Birmingham, AL
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Re: Neuroma but no MRI show...yet surgery??

Since you are in Palo Alto you shuld be able to find a good sports med ortho who is foot and ankle board certified. Try the 49'er's front office, Stanford's athletic department, any professional dance company there, etc - folks who get paid for their physical ability and get foot injuires are good places to find a good foot doctor.

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