Question
I抦 sure this will be the last question. Thanks for answering my previous questions so thoroughly so far.

Where do you find the majority of the neuromas that you treat with cryosurgery? That is, is it usually between the 2nd and 3rd toes, or the 3rd and 4th?

I was diagnosed with a neuroma between the 3rd and 4th but I抦 not sure about it because I have no definitive image.

What I really want to know is do patients come to you knowing where their neuroma is already?

Lastly, have you had any patients come to you as a first choice, before they抳e tried the traditional treatments such as cortisone injections?

I would guess unlikely because after recently visiting message boards, I'm seeing many sad stories of failed injections and surgeries. Cryosurgery isn抰 even mentioned as an option so I抳e been trying to raise awareness of it.

Thanks again


Answer
Hi Jeff,

No problem, ask as many questions as you need.

The most common area that I treat with a neuroma or Morton's neuroma would be behind the 3rd and 4th toes.  The second most common site is between the second and third toes.  A neuroma can occur at any nerve site in the foot.

Many of the patients that I see have been treated for neuromas and know the location told to them by their previous Dr.  However, I have found that the location in about half of the cases may be incorrect or there may be 2 sites.  The pain from a foot neuroma can radiate throughout the forefoot and even into the arch and the exact location may be difficult to identify by the patient.  I also get many patients that have severe pain and have never been diagnosed with a neuroma and that is their problem.

I will typically try injections and other conservative therapy prior to doing Cryosurgery if the patient has had no prior treatment or what I believe to be the correct treatment.

You are correct, there are many people with terrible stories of failed surgeries.  In my practice, I do not remove the nerve to correct neuroma pain.  I've found that the success of Cryosurgery is far superior to traditional nerve removal.  I know that some people have the nerve removed and do fine.  However, there are too many poor results out there to justify nerve removal.

Cryosurgery has been around for over 20 years and you will see it becoming a more common option.  I am working hard trying to spread the word.  I also talk with many Podiatrists and train some of them.

Good Luck.

Sincerely,

Marc Katz, DPM
Tampa, FL
Advanced Podiatry
www.thetampapodiatrist.com
www.tampacryosurgery.com
www.fix-my-foot.com

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