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Foot and Ankle Specialists
1230 Whitehorse Mercerville Road Hamilton, NJ 08619(609) 585-0500
11 Overlook Road Suite 140 Summit, NJ 07901(908) 273-0056
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Morton's Neuroma

How to Successfully Treat a Morton's Neuroma Without Getting a Stump Neuroma:

 

1.  Decompression Procedure:

This technique is used when preservation of the nerve function (sensation) is desired.  A "stump neuroma" is not possible to occurr with this procedure.  This procedure is best for neuromas that have not had any attempt at prior surgery or destructive treatments (chemical alcohol or other ablations).  The procedure is usually about 30 minutes and you can walk the same day.  A small incision is placed on the top of the foot and the tight bands that bind down the neuroma are released.  The neuroma is "un-pinched". This can be done minimally invasive using an endoscope (the size of a pencil).  Only mild sedation and a local anesthetic are required.  Most patients return to sneakers at the 4th week after surgery.   Numbness and tingling may improve if nerve damage is not advanced. This procedure is effective in men more than women, due to differences in heel height that places more weight on the forefoot.  

Call us today or click here to request a consultation.

2.   Radiofrequency Ablation

Since 2010, we have been utilizing ultrasound-guided radiofrequency ablation (RFA). Ultrasound-guided RFA  is a  minimally invasive procedure that uses high-frequency sound waves to heat the sensory nerve/neuroma. Once heated, the nerve no longer effectively transmits pain sensation.  The nerve is destroyed and usually offers long-term results and high patient satisfaction. However, sometimes more than one treatment is required.  It may not improve any numbness that may already have occurred.  It is best applied to neuromas that already failed decompression or alcohol or stump neuromas.

Image result for stryker radiofrequency ablation 

The procedure is minimally invasive and is performed under local anesthesia.  Outcomes are optimized using ultrasound imaging and nerve stimulation to ensure correct positioning. Occasionally the RFA may need to be repeated for best results.  A stump neuroma is not possible with this treatment

2. Cryoablation

Ultrasound-guided cryosurgery (also known as cryoablation)  generates extremely cold temperature to destroy neuroma tissue.  We use ultrasound guidance to increase the effectiveness of this treatment by ensuring the correct placement of the probe tip.  This procedure is sometimes repeated if needed.  A stump neuroma is not possible with this procedure.

3. PRP (Platelet Rich Plasma)

Platelet-rich plasma (PRP) treatment is the injection of the patient’s own platelets to treat Morton’s neuroma. It is used for other disorders, such as of injured tendons, ligaments, muscles, joints. 

Image result for arthrex PRP

Ultrasound imaging is used to guide the injection and this increases the accuracy of the PRP procedure.   Occasionally, additional injections may be needed.  There is not enough data to clearly state this treatment is effective by itself or when combined with other treatments.

 

Did you already have neuroma surgery, but are worse now?

Don't worry, even if you already had your neuroma removed and still have pain there is hope for pain relief.  Radiofrequency and cryoablation may be helpful but will require more than one treatment due to dense scar tissue that usually forms around a stump neuroma.

 

When should I remove my Morton's Neuroma?

 

10% of Morton's Neuroma do not improve with the above treatments and surgical removal is sometimes needed

Neuroma surgery to remove the Morton's Neuroma (aka neurectomy) with muscle implantation is a  successful technique. There may be less risk for a stump neuroma with this technique.  If needed, this could be performed from the top of the foot or the bottom, depending on your circumstances, anatomy, and prior treatments.  Request an appointment with Dr. Rockmore 

 

 

Other Non-Surgical Treatment:

Custom Molded Foot Orthotics can help reduce pressure on the nerve.  We use a computer to analyze the movement of your foot to detect abnormalities and to fabricate a superior orthotic.  

Injections, but not into the nerve, can be very helpful.  For best results, administer under the guidance of an ultrasound. Ultrasound guidance has shown to be more effective than blind injections.  This is performed in our office routinely.  Relief may last for many years or be only temporary. 

 

Did You Know That a Morton's Neuroma Is Not Really a Neuroma?   You need to know this to treat it ....

The nerves that are under the ball of the foot are under a lot of weight and they can get pinched, compressed or entrapped.  The nerves to the toes can become pinched, compressed, or entrapped between the bones and underneath a ligament  that travels across the toe joint.  If the nerve is entrapped long enough, it will swell and enlarge, making the nerve even more vulnerable to pressure and increased pain symptoms.  Our job is to reduce the pressure on the nerve, similar to how carpal tunnel release helps carpal tunnel syndrome.

This interdigital nerve compression is widely erroneously referred to as a neuroma.  A neuroma is defined as a damaged nerve. Many neuromas are found at amputation sites and areas where a nerve suffered a traumatic injury.  What is happening in the foot is usually not a damaged nerve, rather it is a compressed nerve.  The difference is huge because compressed nerves require a simple procedure called decompression (neurolysis).  The treatment for a true neuroma is to cut out the neuroma. Cutting a nerve usually leads to sensory loss and the possibility of a very painful stump that would require additional surgery.  The treatment for a compressed nerve is to decompress it and give it room to move around inside the foot, a much less risky procedure that usually improves the sensation in the toes and alleviates the pain.

 

 

Your Symptoms Are:

  • Pain and throbbing on the ball of the foot.
  • Sharp pain that shoots into the toe. 
  • Some patients feel as though their sock is bunched up under their foot, yet it is not.  Others feel as though there is a stone stuck in their shoe.  Often times there may be numbness.

You may also have tarsal tunnel syndrome and that needs to be determined and treated for successful neuroma treatment. If you have symptoms in both feet, you may also have a peripheral neuropathy. We offer painless nerve testing with the Pressure Specified Sensory Device to determine if there is an underlying peripheral neuropathy or tarsal tunnel syndrome in addition to the neuroma. 

 

Learn More

  • Bunion and Hammertoe Surgery
  • Morton's neuroma
  • Heel Pain
  • Neuropathy, Tarsal Tunnels Release, and Pain Treatments

Patient Education

 
Patient Education
  • Posterior Tibial Tendon Dysfunction (PTTD)
  • Accessory Navicular Syndrome
  • Common Disorders of the Achilles Tendon
  • Achilles Tendon Rupture
  • Diabetic Complications and Amputation Prevention
  • Ankle Arthritis
  • Ankle Fractures
  • Chronic Ankle Instability
  • Ankle Pain
  • Ankle Sprain
  • Arch Pain
  • Arch Supports
  • Athlete's Foot
  • Baseball Injuries to the Foot and Ankle
  • Basketball Injuries to the Foot and Ankle
  • Soft Tissue Biopsy
  • Black Toenails
  • Bone Healing
  • Bone Infection
  • Bone Tumors in the Foot
  • Brachymetararsia
  • Bunions (Hallux Abducto Valgus)
  • Bursitis
  • Calcaneal Apophysitis (Sever's Disease)
  • Fractures of the Calcaneus (Heel Bone Fractures)
  • Calf Pain
  • Callus
  • Capsulitis of the Second Toe
  • Cavus Foot (High-Arched Foot)
  • Charcot Foot
  • Clubfoot
  • Cold Feet
  • Compartment Syndrome
  • Contact Dermatitis
  • Corns
  • Cracked Heels
  • Crutch Use
  • Custom Orthotic Devices
  • Cyst-Ganglion
  • Deep Vein Thrombosis (DVT)
  • Dermatitis
  • Diabetic Complications and Amputation Prevention
  • Diabetic Foot Care Guidelines
  • Diabetic Peripheral Neuropathy
  • Diabetic Shoes
  • Drop Foot
  • Dry Heels
  • DVT (Deep Vein Thrombosis)
  • Eczema of the Foot
  • Equinus
  • Extra Bones
  • Fallen Arches
  • Field Hockey Injuries to the Foot and Ankle
  • Fifth Metatarsal Fracture
  • Flatfoot-Adult Acquired
  • Flatfoot-Flexible
  • Flatfoot-Pediatric
  • Flexible Flatfoot
  • Foot Arthritis
  • Foot Bumps
  • Foot Drop
  • Foot Fracture
  • Foot Lumps
  • Foot Odor
  • Foot Rash
  • Football Injuries to the Foot and Ankle
  • Fracture-Ankle
  • Fracture-Foot
  • Fractures of the Calcaneus (Heel Bone Fractures)
  • Fractures of the Fifth Metatarsal
  • Fracture-Toe
  • Frostbite
  • Fungal Nails
  • Ganglion Cyst
  • Gangrene
  • Golf Injuries to the Foot and Ankle
  • Gout
  • Haglund's Deformity
  • Hallux Rigidus
  • Hammertoes
  • Heel Bone Fractures
  • Heel Cracks
  • Heel Fissures
  • Heel Pain (Plantar Fasciitis)
  • High-Arched Foot
  • Inflammation: Actue
  • Ingrown Toenails
  • Instructions for Using Crutches
  • Intermetatarsal Neuroma
  • Intoeing
  • Joint Pain in the Foot
  • Joint Swelling in the Foot
  • Jones Fracture
  • Lacrosse Injuries to the Foot and Ankle
  • Lisfranc Injuries
  • Lumps
  • Malignant Melanoma of the Foot
  • MRSA Infection of the Foot
  • Orthotics
  • Os Trigonum Syndrome
  • Osteoporosis
  • Osteoarthritis of the Foot and Ankle
  • Osteomyelitis (Bone Infection)
  • Osteopenia
  • P.A.D. (Peripheral Arterial Disease)
  • Pediatric Flatfoot
  • Peripheral Arterial Disease (P.A.D.)
  • Peripheral Neuropathy: Diabetic
  • Peroneal Tendon Injuries
  • Pigeon-toes
  • Plantar Fasciitis
  • Plantar Fibroma
  • Plantar Wart (Verruca Plantaris)
  • Posterior Tibial Tendon Dysfunction (PTTD)
  • Pump Bump (Hallux Rigidus)
  • Puncture Wounds
  • Rash
  • Raynauds Phenomenon
  • Restless Legs
  • Rheumatoid Arthritis in the Foot and Ankle
  • R.I.C.E Protocol
  • Rugby Injuries to the Foot and Ankle
  • Running and Track Injuries to the Foot and Ankle
  • Running Injuries
  • Sesamoid Injuries in the Foot
  • Shin Splints
  • Shoe Inserts
  • Skin Cancer of the Foot and Ankle
  • Smelly Feet
  • Soccer Injuries to the Foot and Ankle
  • Soft Tissue Biopsy
  • Softball Injuries to the Foot and Ankle
  • Sports Injuries to the Foot and Ankle
  • Staph Infections of the Foot
  • Stress Fracture in the Foot
  • Sweaty Feet
  • Swollen Ankles
  • Swollen Feet
  • Synovitis
  • Tailor's Bunion
  • Talar Dome Lesion
  • Tarsal Coalition
  • Tarsal Tunnel Syndrome
  • Tennis Injuries to the Foot and Ankle
  • Thick Toenails
  • Tingly Feet
  • Tired Feet
  • Toe and Metatarsal Fractures (Broken Toes)
  • Toe Walking
  • Turf Toe
  • Ulcers/Wounds
  • Varicose Veins
  • Volleyball Injuries to the Foot and Ankle
  • Warts
  • Weak Ankles
  • Webbed Toes
  • White Toenails
  • Wounds/Ulcers
  • Wounds-Puncture
  • Yellow Toenails

Our Location

1230 Whitehorse Mercerville Road
Hamilton, NJ 08619
(609) 585-0500
11 Overlook Road Suite 140
Summit, NJ 07901
(908) 273-0056

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Foot and Ankle Surgery - Podiatrist - Hamilton Princeton Summit Westfield
Hamilton NJ, 08619 (609) 585-0500
Summit NJ, 07901 (908) 273-0056
Nail Fungus Laser, Neuropathy Treatment, Tarsal Tunnel Release, Bunion Surgery, Hammertoe Surgery, Heel Pain, Plantar fasciitis Treatment, Minimal Incision Surgery

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