In my case I have had very good luck with the cryosurgery that I had done in April (along with orthodics, proper shoes and the sub metatarsal wedging under both feet that is recommended on this site), performed by Dr. Katz at tampacryosurgery.com. So far so good. I am now able to exercise as much as I want after having endured several years of pain. I had to fly from Boston to Tampa but I feel that it was very much worth the time and money for me. Good luck.
Thank you so much for your input. Is cryosurgery a one time surgery? I do wear custom orthotics that were made through my physiotherapist, but when I had worn them for 2 weeks the pain intensified in the ball of my foot. I took them along with me to show my Podiatrist and apparently he is the guy that designed them. He took it apart for me and added cushioning support right there in the office and I walked out with a much more comfortable orthotic. The only type of shoes I wear is sneakers. I can't wear heels or anything heavier than a running shoe because of the foot drop.
I appreciate your input. thanks
Yes I believe that the cryosurgery is usually one time although Dr. Katz told me that some people need to have it repeated. My foot is about 95 percent better than before the surgery. I have some minor aches but nothing compared to the pain, tenderness and burning that I had before. I would repeat the cryo down the road if I had to but I am hoping that I have made positive changes to improve my gait so that it won't be necessary. I only wear sneakers as well because I don't want to mess up my foot again. I also follow the concepts in the book, Chi Running. I changed my running and walking form and focus on lifting my forefoot more just before landing and relaxing my whole body except for my core which I engage. I realize that the cryosurgery is controversial because you are intentionally destroying a nerve but from what I have read the nerve grows back and the cryo can be preferable to traditional surgery because a portion of the nerve is left so if it grows back there is little chance of a stump neuroma. If you decide be sure that the Dr. is good. I was happy with the one I chose. Best of luck.
Now that prolotherapy has strengthened my foot, I feel the damaged nerve regenerating each month past the neuroma area, it feels like a small vine growing in your flesh, there are growth spurt days and nothing days, the new growth has reached to just behind the toes, lots of itchy, tingly, burning wierdness.......I know I would never go cryo and have to regrow this thing again in a few years..............just a thought. Fix the root problem which is not your gait, its your age, meaning your foot took a lifetime of wear and literally is ripping apart, The "apartness" is the root problem.
I'm not sure if you intended to reply to my message in your original post, or if you simply clicked "reply" on the last post at the time, but I'll address your question anyway. If you've read much of my stuff you can probably tell I'm not a big fan of surgery, for other reasons including potential nerve damage as may be your case (peroneal nerve?), but it may be too late to discuss that. With any luck, perhaps there is scar tissue resulting from the hip surgery that has put pressure on a nerve trunk leading to the area of dysfunction, but I doubt it. It is also risky opening people up to see. Perhaps there is an MRI that can illuminate the problem, but for now you must deal with it.
SInce the drop foot results when the dorsiflexors are dormant, it occurs to me that dorsiflexion may not be necessary when your plantarflexor muscles are much more powerful than their weaker antagonists, if you'll pardon the redundancy I use for emphasis. If I were you - and I offer this in all seriousness - I'd hook a long bungee cord from my waist band to the lower laces of my shoe to mimick the dorsiflexors and take 'er out for a spin. The plantarflexors already take on a much greater load than that bungee just propelling you forward, let alone running, but I digress.
Meanwhile, there is that neuroma factory down there. Please note that neuroma surgeries are not final. The tendency to create one (or two in your case) is a virtual guarantee to create more if the cause is not removed. Much surgery as medicine is remedial and practiced as a last resort. The only preventive surgery I could see would be 1st to restore function to your foot and 2nd to remodel the bone structure to make neuromas unlikely. This is rarely done and probably not covered by insurance, and yes there would be huge risks involved according to accounts I've read but failed to bookmark. My money's on the bungee - or some high tech equivalent.
You asked whether drop foot is known to lead to neuromas. A brief search found no discussion of this, but in my opinion it goes without saying, and the Dr's conclusion is logical. This is why I keep thinking Cause and not about endlessly chasing Symptom. I did however, find a short discussion of potential nerve damage during hip surgery.
Another possibility occurred to me as an afterthought, even though it concerns my area of expertise. Surgery often causes muscular spasm, and hip surgery would be likely to cause some dysfunction in the muscles of the hip, some of which might be dangerously close to branches of the Sciatic Nerve, which of course feeds the Peroneal Nerve that is apparently not activating your dorsiflexor muscles. Knots called trigger points are potentially powerful enough to do this in the right location(s), but muscles in spasm also tighten other structures through which nerves pass, including vertebrae like L5, an area that is associated with drop foot and tends to be one of the first to weaken with age.
A piece of information that could help is whether or not your drop foot is accompanied by Trendelenburg or stepping gait, both evidence of hip muscle dysfunction. Meanwhile, lets look at some of the interweaving that goes on between muscles and nerves... http://en.wikipedia.org/wiki/Superior_gluteal_nerve
Tracing upward from the Peroneal nerve that activates dorsiflexion, you can see its origins in the jungle of gluteal muscles illustrated in the link above. Note the powerful hip rotator muscle Piriformis which in some persons wraps around the Sciatic Nerve that carries nerve impulses to your lower leg. Problems with this and other nuscles in the gluteal area could conceivably affect portions of the Sciatic Nerve. It would be interesting to see if palpation and manipulation of this area could restore some function, but this may already have been tried after your unexpected condition was discovered. Prognosis in these cases is normally not good but if not tried it's worth a shot, especially if the onset was not immediate but gradual.
Ok, I've given you enough to think about for now, so I'll go about my business, wishing you every possibility of full recovery.
Thank you James for all the information. Yes, my origional post was meant for you, but I was also happy to hear from others as well since my conditon seems to be a little more unusual than the normal. I've been away for a bit, so I do apologize for taking so long to get back to you. The pain from the neuromas had gotten so bad, that I did have my foot injected in two locations. I am happy with the result, and understand it's temporary but now I should be able to manage all my canning this summer before needing the surgery. My foot specialist discovered something strange, and wants my physiotherapist to investigate. He believes that I also have Scoliosis. He added a 1/2" height to my left orthotic heel, and in doing so I am walking much more level, I am not losing my balance as I was occasionally doing. My affected side is my right side. Now my right foot is coming down with the weight more centrally. It had been coming down more around the big toe area. This is a huge improvement. Going for walks is much more comfortable. The idea of yours to use a bungy cord is very interesting. I think that several months back, I could have benifited from it. Presently though, in all appearances my walk looks normal. The ball of my foot comes down only a little bit harder than my left foot. It's getting better all the time, and I am amazed that my right ankle is very strong from all the hard work it has had to do. I have been told that I should recover fully from the drop foot. There is no scarring of tissues. I was told the cause was just from the stress of the surgery. It's been a long process.
I had a MRI done on my right foot, but have not gotten the results back yet. I have an appointment to see my physiotherapist this afternoon. It's going to be interesting to see if I do have Scoliosis.
Again, James thank you for all your information. I appreciate any of your comments.
The good news about scoliosis is that it is usually an adaptation or condition, not a disease. The bad news is the the longer it takes to eliminate the cause of the adaptation, the longer it may persist, and the longer it may take to correct. In some cases the adaptation may become permanent since bone can remodel itself over time in response to repeated stress.
Typically, there is a difference in leg length, arch height, pelvic symmetry, or hip muscle dysfunction that forces the spine to right itself, usually in a simple lateral S-curve, which is probably in your case lumbar dextroscoliosis (leaning to the right away from the "shorter" leg, and thoracic levoscoliosis (leaning to the left) to correct (sometimes over-correct) the angle, which is often further corrected by dextroscoliosis in the upper thoracic and/or cervical vertebrae to center the head over the pelvis. Whew... all because of a simple leg length discrepancy.
Of course, a tilted or asymmetric pelvis may present a dilemma to the hip rotator muscles, which can torque the femur to adjust tension and present another problem for the foot - under all the weight of the above structures - to adapt to. Perhaps this is what you have seen in your case. I wore a wedge in my left shoe for a while to correct a problem with MN, but I removed it later after I started to develop ITB syndrome in the left knee. I still use a tough gel pad just a few millimeters thick in the left shoe, but I seem to have reached muscular equilibrium, knock on wood. Most of a year and a few marathon-length runs later, things are under control. Once again I want to underscore the often temporary nature of adaptations.
When scoliosis is a more difficult problem to solve, there may be a neurological component, either in the central nervous system (which may be impossible to correct) or in the form of a pinched nerve down the spine or elsewhere that can sometimes be corrected. More complicated rotoscoliosis involves the twisting of the spine on its axis, which is even more difficult to trace and correct. Adaptations to this kind of scoliosis can be severe, because the twisting can result in more nerve impairment and a viscious circle of more scoliosis and further adaptations.
The good news is, it sounds like you are on the mend... so good luck to you in your prognosis and complete recovery!
I have been dealing with a Morton's Neuroma for about a year and a half. I've had an MRI, Two Cortiozone injections, orthodics, wider shoes. My foot is still sore.
The Foot Doctor said, I may possibly have a double Neuroma (in one foot).
Nothing shows up on the MRI. I've heard that it doesn't always.
Not sure what to do now. Just fed up. The alcohol injections were never offered. I'm glad to hear of them on this web site. I've been to two foot doctors and the last one, would hardly listen or pay attention, until, I showed an interest in possibly having the surgery. I guess, they don't make much money, just talking.
I have been struggling with pain in the ball of my foot for months. I am a relately new runner and I run half marathons.
Anyway, my doc wanted to do cortisone shots and custom orthotics but I didn't want to spend the money and my pain has not been that severe. I have found a lot of relief from icing daily. I soak my foot in ICE water for atleast 10 minutes daily. I wear crocs around the house. I use Healthy Toes toe stretchers in the evenings. I have occassional pain but it is maneagable.
If you are just starting with this kind of pain, try the ice water soaks. it has been be so cold that I can hardly stand it. I have 2 dish pans, one for ice water, one for warm water, 30 seconds in each pan, alternating for as long as I can manage.
Newbie (wannabe) Runner
5k- Nov 20, 2010 38 mins
5k- Dec 7, 2010 36 mins
Snapple High Could Half Marathon 3:15
Half Marathon, Shamrock- March 20, 2011
Cherry Blossom 10 miler April 3, 2011
Warrior Dash May 21, 2011