Question
I was diagnosed with a Morton's Neuroma a year ago. Had 2 cortisone shots and Physical Therapy. Ok for 6 months, pain back again. Surgery scares me. I want to try some custom fit Orthotics for pain relief on my Neuroma. These inserts can start at 10 degrees and can work up to 40 degrees for corrective measure. They say the more pressure that can be relieved from the nerve, the more successful the treatment. What is your feeling on this method, or is cryosurgery the best alternative?  

Answer
Joseph,

I think it is reasonable to try orthotic devices before considering any foot surgery.  With neuroma's there is a lower rate of success with orthotic devices.  Also, if you post an orthotic according to what you have mentioned above, you will likely be falling out of your shoes.  Maybe ten degrees but even that is not typically tolerated.  It has been my experience that posting is not the key, rather the amount of actual arch support.  Many would disagree with me and strictly stick to science.  I believe that orthotic devices are mostly an art and less a science.

If that doesn't work, I believe cryosurgery is excellent for neuromas.  I no longer perform the nerve removal procedure.  The results are questionable in my opinion.  And the postoperative course can be a challenge.

Hope all goes well.  Feel free to ask further questions as you progress.

Sincerely,

Marc Katz, DPM
Tampa, FL
Advanced Podiatry
http://www.theTampaPodiatrist.com
http://www.TampaCryosurgery.com