Do you have questions about foot care? We have answers.
Do you have questions about foot injuries or the causes of foot pain? Tanglewood Foot Specialists provides the answers to frequently asked questions (FAQs) about foot injuries and foot care. If you would like to schedule an appointment to talk to a doctor about your foot pain, call Tanglewood Foot Specialists at (713) 785-7881.
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Which "off the shelf" insoles are the best for a neuroma?
Foot pain is big business...just take a look at late night infomercials, the foot-care aisle in the pharmacy, SkyMall on an airplane, or the retail stores that prey on those suffering with foot pain. Not all insoles are created equal, however.
Two elements of an "off the shelf" insole is needed to reduce pressure on a Morton's neuroma. The first is control of hyperpronation. The "rolling in" that is caused by pronation causes compression of the metatarsal bones. I have found the best insole for this purpose to be Powerstep insoles which we carry in our office.
The other element needed for control of a Morton's neuroma is metatarsal arch support. This is hard to find on an OTC insole. In the office, we add metatarsal support to the Powerstep insoles dispensed for a neuroma. There are few insoles that come "off the shelf" with this support effectively added.
A quality insole should cost in the range of $30-$60, whether it is purchased in a shoe store, online, or a Houston podiatrist office. Unfortunately, there are those who charge in excess of $200 for a generic insole. If you are asked to pay this amount, or to invest in several different pair of non-custom insoles, you should beware.
There are times when a non-custom insole is enough to alleviate pain from a Morton's neuroma. The foot and ankle specialists at Tanglewood Foot Specialists will be able to recommend the best insole, or custom orthotic, for you.
Are there any special injections to make my neuroma go away?
The most common injection used to treat a Morton's neuroma is a corticosteroid injection. Cortisone, however, only treats the inflammation and not the neuroma itself. There are other injections that do address the actual neuroma.
A series of injections utilizing absolute alcohol is often effective to shrink the neuroma itself. This treatment is known as sclerosing injection therapy. The series usually lasts seven weeks, with one injection administered each week. While no treatment is effective for everyone, when these injections are successful they are able to prevent surgery.
While a corticosteroid injection provides pain relief that is close to immediate, a sclerosing injection works differently. After the initial numbness of the anesthesia wears off, some people report an increase in the pain from the neuroma prior to experiencing pain relief.
If you have attempted other treatments for a Morton's neuroma which did not have good results, contact your Houston foot and ankle podiatrist at Tanglewood Foot Specialists for a comprehensive evaluation. We will offer you the full range of treatments in order to allow you to walk pain-free.
What causes a neuroma to form?
A Morton's neuroma is a swelling of a nerve in the forefoot. The swelling is due to the pressure of the adjacent metatarsal bones on the nerve. This pressure also causes the nerve to become inflamed, which is primarily responsible for the associated pain.
Certain factors may contribute to the formation of the Morton's neuroma. Narrow shoes and shoes with a pointed toe box cause increased compression of the bones in the forefoot, thereby increasing the pressure on the nerve. High heels also can contribute to a neuroma, since they increase the pressure on the forefoot. For these reasons, a Morton's neuroma is more commonly found affecting women.
If you feel that you are beginning to suffer the early symptoms of a Morton's neuroma and feel pain in the ball of the foot, the first step you take should be to evaluate your shoes. Try to wear the widest shoes that still fit your feet. Very often, this change alone can remove pressure from the nerve and reduce or eliminate the pain.
If you continue to feel pain, contact your Houston foot and ankle specialist at Tanglewood Foot Specialists. The Houston foot and ankle physicians and surgeons can evaluate your condition and recommend the best treatment to get you out of pain.
Can shockwave therapy cure my neuroma?
Shockwave therapy is a newer treatment for different forms of inflammation. It is commonly used to treat resistant heel pain caused by plantar fasciitis or Achilles tendonitis. The two most common forms of shockwave therapy is Extracorporeal Shockwave Therapy (ESWT) and Extracorporeal Pulse Activated Therapy (EPAT).
Shockwave therapy can be used to treat pain from a Morton's neuroma, although it is not as commonly used as it is for heel pain and tendonitis. The therapy would serve to eliminate the inflammation of the neuroma which will control the pain. It does not, however, eliminate the neuroma itself. It is possible that the inflammation can return with time and a custom orthotic should be used to help to minimize the continued pressure on the nerve.
If you feel that you want to use a safe treatment with no need for medication, injections, or anesthesia, then EPAT is the right choice for you. Contact your podiatrist in Houston to schedule an appointment.
Do neuromas come back after surgery?
Nerves are unable to regenerate, which is why spinal cord injuries that lead to paralysis are permanent. Because of this, the portion of nerve that is removed in surgery for a Morton's neuroma does not heal together or regenerate. It is also why the surgery to remove a Morton's neuroma leads to some numbness in the toes.
It is possible that a neuroma can form on the end of the nerve that is cut during the surgery. This is an infrequent complication known as a stump neuroma, which can cause a return of neuroma-like pain. The pain is often able to be controlled with conservative measures, such as cortisone injections, but sometimes require an additional foot surgery to correct.
Don't let that scare you away! Complications from neuroma surgery are extremely rare. While they do occasionally occur, they can be managed. The relief you'll most likely find with successful treatment for a Morton's neuroma will be swift and complete. Contact your Houston podiatrist today for an immediate appointment.
How does neuroma surgery work?
Neuroma surgery is one of the more straightforward foot surgeries there is. The neuroma is an inflamed swelling of the nerve. The surgery to correct a Morton's neuroma involves identification and removal of the swollen piece of nerve.
Because the enlarged portion of the nerve is removed, the pain associated with the neuroma is eliminated. In many cases the patient realizes this improvement soon after the surgery. After surgery, the patient is able to bear weight on the foot immediately, in most cases.
Don't let surgery scare you away. Like most surgeries it is a last resort. Neuroma surgery, when indicated and performed, is one that is very successful. Contact your Houston podiatrist to schedule an appointment to evaluate the pain in the ball of your foot and recommend the best treatment for you.
Is there anything other than medicine or a cortisone shot that will help relieve a neuroma?
While anti-inflammatory medication, whether oral or a cortisone injection, is often helpful to reduce the pain of a Morton's neuroma, there are other treatments that are also effective. A series of sclerosing injections are useful in shrinking the neuroma, not only addressing the inflammation. These injections utilize dehydrated alcohol to accomplish this. While many patients do respond to this treatment, there are always some that do not.
Because the inflammation of a neuroma is caused by pressure on the nerve, relieving that pressure helps the inflammation to resolve. Incorporating metatarsal support into a custom orthotic device is the best way to achieve this. The metatarsal support allows the metatarsal bones to spread apart and reduce or eliminate the pressure on the nerve. In most cases, the orthotic will be used in combination with another treatment
Not all treatment options are right for everybody. Be sure to contact your podiatrist in Houston to schedule an appointment. The doctor will be able to provide you with the appropriate recommendation.
Can you see a neuroma on X-Ray or MRI?
A neuroma is an inflammation of a nerve in the ball of the foot. Because the nerve is composed of soft tissue, it is not visible on X-ray. X-ray is useful to image bone and does not provide much diagnostic benefit for a Morton's neuroma. Even so, your podiatrist in Houston will likely order an X-ray to be taken, since it is important to rule out other issues, such as a stress fracture.
An MRI is very useful in imaging soft tissue structures, such as neuromas. An MRI is not always necessary if the clinical evidence for a neuroma is overwhelming. In fact, an MRI can produce a false negative for Morton's neuroma, meaning not finding one even if a neuroma is present. This happens when the neuroma falls between the "slices" that the MRI takes.
Can ibuprofen stop a neuroma from hurting?
In most cases your pain associated with a Morton's neuroma is due to inflammation of the nerve traveling through the ball of your foot. Because of this, an anti-inflammatory medication, such as ibuprofen or naproxen, can help to control your pain. This medication can reduce the inflammation surrounding the nerve and stop the neuroma from hurting.
When OTC medication is not enough to manage your neuroma pain, your podiatrist in Houston can take additional steps to relieve the pain that the neuroma is causing. Prescription strength anti-inflammatory medication will be more effective to reduce the inflammation and eliminate the pain. There are many other treatments to stop the Morton's neuroma from hurting as well, including cortisone injections.
Don't let ball of foot pain caused by a neuroma stop you from the things you love to do. If medication does not help quickly and completely, be sure to contact our Houston office for a comprehensive evaluation.
Can You Use Biofreeze For Neuropathy?
People who are suffering from peripheral neuropathy in Houston are on a constant lookout to help to moderate their symptoms. There is an overwhelming amount of remedies, however, some of which work better than others. Biofreeze, a topical analgesic, is one such remedy that helps to provide temporary relief from the pain from peripheral neuropathy.
Biofreeze is a topical analgesic which comes in gell, roll-on, and spray form. It started as a commonly used sports' pain relief gel but has since become much more widely used. Biofreeze contains Ilex which is an herbal extract that aids in producing its therapeutic effect. Unlike other sports gels, Biofreeze only has a cold therapy, which helps to reduce inflammation.
Biofreeze is effective for many people in helping the burning pain often associated with peripheral neuropathy. I typically recommend the spray form, likening it to a fire extinguisher to spray away the burning. Biofreeze can be used throughout the day and offers no adverse effects.
We always carry Biofreeze in our Houston podiatry offices. If you would like to pick some up to try, give us a call and come on in. No appointment is necessary!
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