Well greetings, I'm here to talk to you about neuromas.
Neuromas. I know I talk a lot about this, I have a website called NeuromaSecrets.com and
that's the second most common problem we see here in this practice besides plantar fasciitis being
number one. Neuroma is number two. So why do we have such a big problem with neuromas?
Well, the nice narrow shoes that everyone likes to wear and the shoes without padding,
they're the two most common problems why we get neuromas.
So what are neuromas? Right here.
Right here shows an inflamed nerve in between the two knuckles. What can we do about it?
What are the treatments?
Well, the neuromas are inflamed nerves in between the metatarsal heads as you can see,
caused by like I said, tight shoes that causes a squeeze of the metatarsals
causing the nerve to get inflamed, or if you wear shoes without padding on the bottom
you get, I would say, you get inflammation of the joint
and inflammation of the nerve on the bottom.
Those are two most common causes that we see why you have neuromas.
Now what's the big deal about neuromas?
Well, one of the typical treatments for neuroma is -- after exhausting conservative care,
people -- surgeons will go ahead and cut the neuroma out.
It's called neuroma excision. It's a fairly common procedure that we do,
but unfortunately, it is very risky as far as complications.
You never know who's gonna do well and who's not gonna do well with the neuroma surgery.
It's rewarding when it goes well and disastrous when it does not.
Again, we don't know. Stump neuromas are very common,
I mean, studies have shown as high as 50%, some say 20% of people end up with it.
Well if you're in the unlucky 50 or 20%, your life is going to be terrible.
So what do we have? Well that's why I look for alternatives when it comes to that.
And the alternative that I found that's great is we have radiofrequency ablation
where I go in and I burn the nerve or what we're discussing in the -- right in the following of this,
is a patient that had what we call a decompression.
Decompression with translocation of a nerve.
What does that mean in English? Basically, I show this to my patients when I talk about this,
if you look at this right here, let me see this right here,
if you go ahead there's a ligament on top -- we're looking from the bottom up --
there's a ligament on top of that nerve, there's ligament right here,
it's on top of that nerve and that's your neuroma.
There's neuroma, that same ligament on top of that nerve we're looking from the bottom up,
cut that ligament right here.
We cut that ligament surgically, open you up, cut the ligament surgically
and then we take that nerve which is on the bottom, we move it above that ligament
and suture it to the joint capsule.
So essentially I'm taking a nerve that is... let me see, got a good picture here,
a good picture right here, essentially I'm taking a nerve from the bottom
that runs right here on the bottom there's a ligament right here, a ligament from the --
a nerve from the bottom, there's a ligament right here that we're talking about,
the deep transverse metatarsal ligament,
the same ligament as I showed in the other picture,
I cut that ligament, the nerve is lying here and I move the nerve all the way to the top.
It's very easy to do, free it up from the soft tissue, move the nerve from the bottom of the foot
to the top of the joint capsule and I sew that nerve onto the joint capsule.
Why does that make a difference?
Well number one, you're not walking on that nerve anymore so that's why it makes a difference
and right now you're gonna see a patient that had this done and take a look at the scar,
she's at three weeks out.
Hear her story and this is very typical of our patients that have had that done. Thank you.
Any pain? "No."
Any pain? 'No." Good.
So I think you'll recover very well. "Okay."
Okay, well thank you for being an awesome patient we're gonna watch your recovery,
see you back in six weeks and it should be all done. "Alrighty, thank you."
You're welcome.