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Anyone else skiing with Morton's Neuroma?

post #1 of 8
Thread Starter 
Any tips on how to deal with it?

Also, has anyone had treatment for it ?(injections, steroids, surgery); I'd like to hear about it.
post #2 of 8
Good fitting boots and custom liners should help a little with pain. I would save surgery for a last resort. Good luck.
post #3 of 8
The voice of experience is here, but I'm not sure I'm the typical neuroma patient. I have MS and my nerves are not normal anyway, but here's my take on the matter.

I developed this around 2004 while working in retail and walking on concrete 9 hours a day. Tt was extremely painful to walk.....like there was a marble in my shoe, and I could move around early in my shift fairly well but I'd be limping and lurching by the end.

I tried cortisone injections and it worked for a couple of days, but it was more painful the first couple of days after the shots. We decided to do surgery and nerve was removed.

Well, it came back with a vengeance and in a year or so it was like walking on a golf ball. Add to it the sensations in the toes from having nerves cut out....it was like having novocaine in the toes that was just wearing off (you know the tingling and 'fat' feeling?). That feeling was just a pain in the arse. It still is. If I bang those toes it just sends me up a wall. I'm constantly aware of it. Cutting my toenails feels like taking that novocained lip and scraping it with a rasp.....ouch.

More cortisone injections, without result. Custom footbeds were made with a movable pad. I tried to move that pad around so that it was comfortable to walk around in street shoes, but no matter where I put it, it just felt like I had the neuroma AND some hard thing in my shoe. Scrap the custom footbeds.

The second surgery was done, but a different podiatrist. That was done in Oct. 2006, and then in Jan. 2007 I broke my leg. Instead of 'taking it easy' on the healing neuroma foot, it became my ONLY foot for walking for some time. I'm sure that didn't help the healing process.

Now I'm back to the golf ball again and I'm not sure what to do from here on, but I don't have that as a priority right now. My neurologist said that it could be an MS symptom, and prescribed a Lidocaine patch. When the pain is bad, I stick one on the foot and sleep with it. It does help.

As for skiing, it never really bothered me all that much. I got new boots in 2005, and they're a great fit. I wear a thicker Smart Wool ski sock with them and the pressure must be just right because it doesn't bother me till late in the day. Taking them off....that's another story!:

I would definitely try the cortisone injections first. The footbeds are non-invasive and worth a shot also. Lots of people have great luck with those. I would do surgery as a last resort because the result is permanent, and the sensations that are left behind are extremely annoying.

Good luck and happy skiing!
post #4 of 8
Thread Starter 
Thank you for the information. I'm astonished to hear that cutting the nerve didn't permanently eliminate the pain.
I had no intention of having that surgery, but wanted to know what experience other people had with it. Your experience is a fair warning.
I was thinking of the injection that supposedly kills the nerve, without cutting it. If cutting it didn't work for you, maybe the injection won't either...

I have very expensive custom orthotics in my custom boot liners. I'm sure the problem would be worse without them.
For skating, blading and hiking I use a home made pad that cushions the foot all the way up to the point of the neuroma; then ends. This prevents the spot from touching the footbed of my skates.

Adding yet another layer inside my ski boot is another matter altogether. Aside from the aggravation and difficulty of trying to keep things in place while squeezing my foot into a ski boot, there's the matter of changing the proportions and relationshiips of all the other places where my foot makes contact with the inside of the boot.
I took a vicodin for the last few hours of skiing the other day. That worked. I also took a non-drowsy allergy pill to deal with the itching I normally get from vicodin and other opioids.
post #5 of 8

I'm not a foot doctor, but here's what I know about the treatment of Morton's neuroma...

There is insufficient clinical evidence to support the use of corrective insoles, NSAIDS, narcotics, physical therapy, or corticosteroid injections for long-term relief from this often very painful and sometimes debilitating condition.

A recently published prospective series found that alcohol injection (to "kill the nerve") of Morton's neuroma has a high success rate and is well tolerated, but this study did not have a control group, a major methodological flaw in the study design. A recent retrospective study (even more methodologically flawed) had similar results, and also found that success was more likely with 5 or more injection sessions.

Imho, alcohol injection therapy might be a reasonable first step to consider, and if that fails, surgery may then be a reasonable next step. For myself personally, I opted for the most "surefire" option, which was surgery. That was over two years ago, and there's been no recurrence since.

A recent Cochrane analysis of treatment options for Morton's neuroma found insufficient evidence to support any treatment other than surgical excision for refractory cases. That same analysis found that transposition of the transected plantar digital nerve may yield better results than standard resection of the nerve in the long-term, but the objective literature comparing surgical techniques is very limited. In the vast majority of patients, surgery provides excellent long-term relief, and in the small minority that still have pain, a second operation is successful 80% of the time.

I hope that helps.
post #6 of 8
Thread Starter 
Thanks for the information.
The padding that I put inside my skates and hiking boots keeps the crucial point of my foot from making contact with the footbed, and I have absolutely no symptoms.
It doesn't make much sense to have surgery just to keep skiing. Maybe I can buy the materials that bootfitters use and recreate what I've done in my skates and boots, in my ski boot.
post #7 of 8

I've been skiing with MN in both feet for at least 10 years.  Under no circumstances buy/rent boots that hurt in the store.  Try them on and walk around for at least 45 minutes and longer - even if the sales clerk isn't staring.  You will have to give up using your toes to control (which you would have enjoyed with tight boots) your skiing.  But your main goal, or at least mine has been, to avoid surgery at all costs.  You should aim for a boot that feels like a marshmallow while your foot is sitting inside.  Try going up a size or two in the boot, or even three so that you have plenty of room in the toe box - you can always cinch up the ankle area if you need.  Try the inserts that you can buy through a 'smart foot' store or use the kind that fit over your foot like a sleeve which you would use under your socks.  You might be able to get a cortisone shot to get you through ski season, but you really haven't addressed the problem is the only way to alleviate the pain.  My first podiatrist said that I would need surgery within the year.  Well, by buying properly fitting shoes/boots, I've beaten his prediction!  Good Luck to you. 

post #8 of 8
Thread Starter 

Since I started this thread I've essentially neutralized the neuroma myself.

A description of how I did that is on the other thread I started here in the Fitness Injury Recovery section.

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