Podiatry - Morton's Neuroma
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Neuritic type pain (stabbing, burning or
shooting) that radiates from the ball of the foot distally into the digits.
Pain may or may not be associated with the numbness of the involved toes.
Initial Diagnosis and Management
- History and physical
- Appropriate radiographic
(weight-bearing foot series to rule-out metatarsal stress fracture) and
laboratory evaluation (metabolic evaluation to rule out causes of distal
sensory neuropathy in patients with bilateral or multiple digit
Ongoing Management and Objectives
Initial primary care treatment should
consist of a three-month trial of the following: NSAIDS, over-the-counter
soft insoles (i.e., Spenco), soft supporting shoes with a wide toe box
(running or walking type), decreased activity (rest).
Indications for Specialty Care Referral
- Patients without improvement of symptoms
after the three-month trial period patient can be referred to the Podiatry
Clinic for the following treatment cascade:
- Metatarsal arch pad installation and
cortisone injection series (three separate shots/9 weeks apart/placed
dorsally to plantarly between the metatarsal head impingement area).
- All Retiree's, VA and dependants with foot conditions 30, 31, 01, 02,
03, 04 etc.. Respectfully need to be routed to Scholfied Barracks Podiatry or net worked out for
treatment. Tripler Podiatry unfortunately does not provide orthotics or inserts for dependants, VA or
Criteria for Return to Primary Care
Patients will be return to the primary care
provider for chronic management after the injection series (nonsurgical
patients) and/or after surgery.