|
|
 |
|
|
Stop the Pain of Morton’s Neuroma
|
|
|
|
|
|
|
|
|
|
|
|
|
Morton Neuromas (Inter-metatarsal neuroma} of the foot is a common problem that results in swelling and inflammation of the nerves, located between the 2nd and 3rd, or 3rd and 4th metatarsals of both feet. It can present gradually over time, or very rapidly when the onset and cause of the neuroma is associated with a particular event. When the pain is chronic, progressive, and clearly related to the amount of time spent walking and standing, the intense and disabling nature of the pain is usually precipitated by a twisting motion of the metatarsal region during weight bearing.
|
|
 |
|
|
|
|
|
The diagnosis is made primarily with a history of signs and symptoms, including:
- Numbness in the early stages between the two involved toes.
- Constantly changing levels of burning pain in the middle of the foot
- Sharp, shooting pain that starts under the metatarsal region, and then radiates into the two adjacent toes.
- Pain with palpation of the inflamed intermetatarsal nerves, and a characteristic “click” with manipulation of the metatarsal bones, are all thought to be classical signs of a Morton’s Neuroma. Computerized imaging techniques will document but are not necessary to diagnose this benign lesion of the foot.
|
|
|
What is the cause of a painful Neuroma?
|
|
|
|
 |
|
|
|
 |
|
|
|
|
|
|
|
Cause: Progressive enlargement of the nerve begins with pronation of the foot as we walk, then instability of the metatarsals, and finally, pressure and grinding of the bones on the nerves.
|
|
|
|
|
|
|
Pronation of the foot, is the critical part of the problem. This complicated movement of all 26 bones of the human foot results in instability and causes breakdown of the metatarsal arch and a grinding motion on the inter-metatarsal nerves. Over a period of time, constant pressure and movement of the metatarsal bones results in inflammation of any or all four of the inte-rmetarsal nerves.
|
|
|
|
Pronation of the foot with break down of the metatarsal arch occurs without orthotic use. Supination of the foot with stabilization of the metatarsal arch ocours with orthotic use.
|
|
|
|
|
|
How do you treat the cause and Stop the Pain?
|
|
|
|
Treatment: Any successful treatment usually involves decreased standing and walking. Patients say it is the only thing they can do to take the pressure off of the nerves and reduce pain. Many treatments just mask the symptoms temporarily. OTC and prescription pain medication, anti-inflammatories, nutritional supplements, and even cortisone injections, provide only partial relief on a temporary basis. As the pain intensifies and becomes more problematic for the patient, the chronic nature of the condition becomes obvious as the symptoms return. These treatments definitely do not treat the cause of the neuroma.Surgical excision of this benign nerve tumor is a common medical recommendation
|
|
|
|
|
|
What do you do when medication, cortisone and alcohol injections, physical therapy, metatarsal pads, arch supports, and prescription orthotics have all failed? What do you do when you have changed the style of the shoes you wear, decreased activity to next to nothing, and done everything but surgery? Even when surgeons fully warn their patients of the inherent risks and poor overall success, patients, mostly out of desperation, consent to surgery.
|
|
|
|
|
|
|
Metatarsal arch pads provide some temporary relief. These pads simulate the transverse metatarsal arch and are placed in the shoe just behind the the metatarsal heads. They act to separate the metatarsal heads and decrease the pressure between the bones and the nerves. They are worth a try those who have know the benefit is generally temporary at best.
|
|
|
|
|
|
|
Does surgery stop the movement that causes the neuromas?
Surgical resection of the neuroma may produce some value on a temporary basis. In the long run, the residual scaring from the procedure may actually aggravate the problem. Certainly, the surgery does nothing to prevent occurrence of another neuroma in any one of three other interspaces. Even if the surgery were without complication and successfully excised the neuroma, it is not uncommon for a patient to develop neuromas in two or more interspaces. It is important to note that all nerve surgery, especially when performed on a weight bearing structure, is unpredictable and often complicated as it heals.
The frequent presentation of this disabling problem in two or more interspaces virtually limits any long term benefits associated with surgical intervention alone. Unless the patient significantly decreases weight bearing activity, surgery does not stop the grinding movement on the nerves caused by pronation of the foot. The same problem in adjacent interspaces or on the other foot is very likely. Re-growth of the nerve in the same interspcace, or even worse, a “stump neuroma”, can occur with some regularity. Even when the surgical excision is successful and without the many complications of nerve surgery in general, it is likely that you will get another one before the first one has fully healed. Brent A Jarrett DPM (Physician and Surgeon of the Foot)
|
|
|
|
|
|
|
05/04/05 Dr. Jarrett, I have suffered from Morton's Neuroma for 25 years. During 22 of those years I had the neuroma removed four times through the top of my foot. It is located between the third and fourth toes on my left foot. Each time, after about a year, it would return and begin to hurt again. The 2nd surgery was performed by a different podiatrist. He said the original surgery was not performed properly and that was the reason the neuroma returned. Sure... Well, the pain did return along with the neuroma and I had it removed again by the same doctor. The fourth surgery was performed several years later by another doctor in another city. Same results.
|
|
|
|
|
Surgical success: Not as good as one might want to believe.
|
|
|
|
I had just decided to live with the pain and did for a number of years. After years of suffering with the pain, it finally got the best of me. This time I went to an Orthopedic surgeon to see if another procedure for removal could be tried. He performed another surgery but he was not real hopeful that my problem would be solved. This time he went through the bottom of my foot. If I understand correctly, in addition to the old neuroma returning, the same thing had happened between another toe and the nerve had wrapped throughout the bottom of my foot. This too had to be removed , complicating the original, supposedly simple surgical plan. Two and a half years later my foot still hurts. The scar runs about 2 1/2 inches on the ball of my foot. All seems to have healed properly in that regard although some minor tenderness is still there. However, I have the neuroma pain coming back again. Believe me, after all of this time I can tell the difference between neuroma pain and other pain. I give up! No more surgery. I am at my wits end. I don't know what to try next, but it won't be surgery. Linda L
|
|
|
|
Decrease pronation, stop arch breakdown, reduce the pressure from adjacent metatarsals, and even provide cushion to the metatarsal area. When you improve foot function, you stop the cause of the pressure inflammation and pain. Ultimately you treat the cause of Morton’s Neuroma.
So why do Most surgeons, and many physicians, tell you that prescription orthotics rarely work in the treament of difficult neuromas. If orthotics do help, it is usually only temporary; or they only stop a small portion of the pain.
|
|
|
|
Stop more Pronation and you will stop more Pain.
|
|
|
|
Many orthotic variations, extensions, pads, and cushions have been added to basic prescription orthotics without providing any significant success in the treatment of the neuroma pain. Grinding motion of the metatarsals on the inter-metatarsal nerves is reduced but only a small amount. Many patients report some benefits associated with the use of orthotic devices with a variety of pads and cushions. Unfortunately, few patients get the help they need, and either quit using the orthotics and just further diminish their weight bearing activity, or accept the risks of surgery. No orthotic variation, extension, pad or cushion currently on the market, other than Theta-Orthtoics, Provides enough help to treat a difficult neruoma successfully.
|
|
|
|
I started treating Morton’s Neuroma patients in 1980 as a surgical resident. I started treating my private neuroma patients with Theta-orthotics In 1985. Once I fully understood theta and was teaching patients what they needed to know in order to apply Theta effectively, the percentage of neuroma patients who went on to consent to at least one neuroma surgery dropped from 50 to 5 percent. Theta should be your treatment of choice and could be your surgical alternative. Brent A Jarrett DPM. Total-Control Theta-Orthotics
|
|
|
|
Some patients with early symptoms get complete relief with just one simple forefoot wedge.(PST)
Others with advanced histories, complicated with surgery, require a custom progressive treatment, with both forefoot and rear foot wedges. Brent A Jarrett DPM
|
|
|
|
|
|
Don’t consent to surgery!
|
|
|
Theta Orthotics with Theta geometry can provide effective treatment for Morton’s Neuroma patients that is not available from any other source.
|
|
|
|
|
|
|
|
Understand howTheta geometry makes Theta-Orthotics Unique
|
|
|
|
Theta Controls the way you walk, run, stand, bike, and dance, from the ground up.
|
|
|
|
|
|
|
- 6 angles of propulsive stage control
- 7 unique angles of midstance correction
- 42 Total Control options
- 25 years of documented research.
|
|
|
|
|
More help that custom orthotics from your local physician, in shoes you want to wear.
|
|
|
|
Stop all the pain progressive treatment that controls both fore foot and rear foot function. Free follow-up.
|
|
|
|
|
|
If you have been diagnosed with Morton’s Neuroma, Theta-Orthotics will help you stand, walk and sometimes even run again, without the pain.
|
|
|
|
|
Dear Dr Jarrett,
I have been plagued with Neuroma problems for over twenty years . I had the Neuroma's surgically removed in 1994 (both feet) . Within three years I was troubled again by the constant stabbing pain which would persist.. that is, until July 2006. I got my first pair of Theta-orthotics , they were 15 's. It took me about 4 days to get used to them. I followed the instruction almost to the tee. I needed this to work. I graduated into the 20's and then the 25's .About the 10 th month my feet were hurting again. I called your help line. Your consultant was so understanding and had just the solution to my problem.
Apparently I didn't read the part that said this would decrease your foot size by re-shaping your foot to take the pressure off the Neuroma's. Well... There I go from a 6 W to a 5... It worked ! It was like having new feet. I was so pleased...
The added and perhaps" biggest bonus" was, that while helping my feet, my need for chiropractic manipulation has decreased ( a lot!). I was walking differently and noticed my lower back had less stress. It has definitely helped with my spinal alignment, (which is key to whole body health.) I am more active than ever now. I no longer have the stabbing pains that only a Neuroma sufferer could know. The only problem I have encountered was the loss of my 30's in a recent move and I am back to my 25's. I have some soreness and discomfort so I have ordered my 30's again and some 35's. I can't wait for them to arrive!
My husbands feet are next! Sometimes he works long days and his feet are sore and tired. I am going to get a pair for him if you suggest these can make just plain old tired feet better?
I have been criticized by several people about buying anything of this nature on line..I assure them the three Podiatrist specialists I have had in the past had never taken a cast of my feet to make custom orthotics like you did. nor take into consideration any of the things you asked on the questionnaire I filled out. They all sent me to Foot Locker.To buy pre made stamped out inserts. My chiropractor sends "we miss you notes" but I just don't need to go.
Well, I trust your orthotics Dr Jarrett, because they work and I would recommend anyone to try them. I can't begin to thank you enough. Your staff members are precious . When I call they are always helpful and friendly... Thank you again for developing these orthotics. Wish I would have known about these a long time ago!
Best Wishes to you and your staff,
Ruby Palmer
|
|
|
|
 |
|
|
|
|
|
If you want our help, but you are skeptical, and find it difficult to believe that medical care over the internet can provide help when your local physician can not. Call 800-558-4382 between 9 AM and 1 PM, MST, Mon-Fri, speak to a treatment specialist who wears Theta, and has helped thousands of patients on the internet. If you still don’t believe we can help call between 3 PM and 6PM MST , Mon-Fri, and speak with me directly.
|
|
|
|
|
My intent is to continue, what I have believed is important research for more than 25 years. Clinically I believe that Theta provides medical help that is not available from any other source. I admonish you to receive the benefits of my life work as you walk more with less pain. Brent A Jarrett DPM
|
|
