TREATMENT PROCESS

This is my current treatment process for neuroma patients; please watch the video for full details. 

• 1st Visit - Evaluate your condition, review x-rays, and perform a walking evaluation to determine the cause of your condition. Start working to reduce inflammation, tightness, and stress through the forefoot and neuroma region.
• 2nd Visit - Will evaluate the initial treatments and, if indicated, perform an ultrasound examination to evaluate the size of the neuroma and discuss further treatments. 
• Cortisone Injection - I use cortisone injections to reduce the inflammation in the neuroma if you are in severe pain.
• Orthotics - Orthotics are useful to reduce pressure, help with posture and reduce excess movement of the foot that can increase stress in the foot.

• Daily Rituals - These daily rituals can be used with other office-based treatments. Towel stretch before getting out of bed (30-second stretch three times), foam rolling (10 minutes 2x a day), icing or contrast baths (10 minutes 2x a day), anti-inflammatory for two weeks at a therapeutic dose, stable shoes with wider toebox and orthotics, Oofos sandals in the house, and avoid going barefoot. 

  • Recommended shoes include brands like Topo, Altra and Lems. Local shoe stores sell them like Sneakerama, Marathons Sports and PR Running.
• Physical Therapy - Rarely, physical therapy is used only for a neuroma, but if other factors contribute to the pain, such as tightness, this may be used for your foot. 
• Shockwave and Amnio Injection - I rarely use shockwave therapy, but it can sometimes improve blood flow and reduce swelling around the neuroma.  At times to help speed up the healing, an Amniotic injection is beneficial. 

RESOURCES 

• Patient Education Slides - Here are the educational slides used in my office. 

• Shockwave (EPAT) - Information about shockwave therapy to promote the natural healing of your own body. 

• Orthotics -  Explanation of how and why orthotics help foot pain.

• Icing and Contrast Bath Instructions - Here is information on icing your foot. 

• Oofos - Recovery sandals to wear at home for more support.

• Shoe Recommendations - Here are my shoe recommendations and shoe-related resources.

• Short Foot Exercises - Exercises to help with strengthening your feet. 

PRODUCTS 

Here are some of the best recommendations I have found on Amazon that might be helpful.