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Monday, January 21, 2019

Morton's Neuroma: Email Advice



Dear Dr. Blake,



I am very excited to have found your blog. I am super impressed with all the information you offer. I've been suffering from a Morton's neuroma on my left foot for the past 7 months per the diagnosis of my Podiatrist upon physical examination. In the past 7 months I have tried multiple treatments. I had completed 3 months of physical therapy prior to seeing my podiatrist where I had been getting treated for a form of tendonitis. I have tried four treatments of acupuncture, which only worked for a day or two. I wore a shoe my orthopedic  doctor gave me for six weeks, his diagnosis being Metatarsalgia. For the past 8 weeks I have wore a pad my Podiatrist gave me and an insert I had  purchased upon her recommendation. Also, I have been wearing shoes with a wide toe box  since mid-September. I ice daily and use essential oils such as lavender, peppermint and rosemary every night. I stopped going to the gym which was very difficult as I enjoy martial arts which involves a lot of pivoting ( down and in) and weight bearing on my left foot. Although  the super intense pain  has improved somewhat, still alot of pain is present. I will be completing an MRI on Monday, January 21st. Hopefully, I will be receiving my first cortisone shot on January 28th. Do you administer alcohol injections for Morton's neuromas with or without guided ultrasound? I'm just trying to think of my next step if the cortisone shot or shots do not help me. Thank you in advance for your time. Is truly appreciated.


Dr. Blake's comment: I was trained way before ultrasound and have had no trouble finding the nerve without. But, some doctors prefer it, so it is a personal call with the one responsible for your health. Today is the 21st of January so send me the report and any observations made and I will attach to this same post as a continuation. Morton's neuroma pain is in essence nerve pain. It is the L5 nerve coming off your low back. I mention this because evaluation should always consider if the pain is only local to the foot, or coming from higher up, or both (called Double Crush Syndrome). Also the treatment should always be mechanical, anti-inflammatory, and neurological. The metatarsal pads, shoes, wide toe boxes, orthotic devices are all mechanical changes. This blog is full of things that sometimes help any individual. Cortisone shots are anti-inflammatory along with the icing. Nerve treatments which help are acupuncture, TENS, topicals like Neuro-Eze or Neuro-One, compounding prescription meds, neural flossing, alcohol shots, oral nerve meds, and possibly low back treatments. Make sure you are always addressing your problem using these 3 treatment areas. Good luck. Rich

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Thank you very much for leaving a comment. Due to my time restraints, some comments may not be answered.I will answer questions that I feel will help the community as a whole.. I can only answer medical questions in a general form. No specific answers can be given. Please consult a podiatrist, therapist, orthopedist, or sports medicine physician in your area for specific questions.