: 1) My foot is swollen and black and blue for the whole two weeks between ejections. It is very difficult to tell if we are making any progress. It is too painful to run on. Is this normal for this kind of treatment?
: Any advice would be appreciated.
Personally I don't use ethanol, though some pods do, hopefully with discretion. I prefer long-acting cortisone, usually no more than 2 or 3 injections, it can shrink the fat pad that protects the forefoot. Most neuromas are stubbornly resistant to injection therapy unless you catch them early and identify more primary causes, like tight achilles tendons, or excess pronation (everyone pronates somewhat with every step normally). A nice leather orthotic is helpful-you may need a different orthotic if it got worse just after the new pair was dipensed. I am concerned about the bruising you're experiencing after the shots. You may want to seek out a doctor with experience in cryoablation, or freezing of the neuroma through minimal invasion. Endoscopic release of the ligament that tranversely binds the metatarsal heads has met some success. Ultimately many are removed successfully through an incision on the top of the foot near the toes, although even in the best of hands reoccurrence happens up to 20%.
So your best bet is to begin with conservative non-invasive treatment, and progress to more aggressive based on the results and your symptoms.
-I practice in the New Haven area-I would ask your MD, your coworkers, your friends for referral to a foot specialist, be they DPM, DO, MD-find someone known for their thorough diagnosis and careful treatment of this painful condition.
In Reply to: Morton Neuroma posted by Robert on March 08, 2004 at 10:07:32: