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Podiatry/Morton's Neuroma


Dear Dr. Tsatsos, I am 59 years of age. I have been an avid high mountain hicker for 24 years, having scaled the likes of Aconcagua (6980m) and Cotopaxi (5897m). High mountain hicking involves 8-12 hour walks in often steep slopes and rough, rocky terrain. It is a repetitive, often intense, low impact activity. In 2009 I stopped mountain hicking due to the appearance of a Morton's Neuroma in my right foot (between 3rd and 4th). It is currently 6mm x 3mm in size. Given that I have flat feet, I use corrective orthopedic supports that allow me to walk comfortably for endless hours inspite of the neuroma, but I can no longer walk on steep slopes for periods longer than 2 hours. After about 2 hours I start to feel the swelling of the affected nerve. After about 4 hours into the ascent the nerve inflammation is considerable.

I have not mountain hicked for 4 years now. I miss the mountain air. I miss my friends........ Its been difficult. In 2011 I had one shot of corticosteroid but it did not help when tested on a long steep trail. The traumatologist suggested a second shot but I frowned on the idea. I had my second shot a couple of months ago mostly out of curiosity - It did not help either. I don't want to go beyong 2 shot as I was told that the stuff can melt your cartilage if you abuse. I have not wanted to have a neurectomy (neuroma excision) because I was told that when you cut the nerve it will attempt to regenerate, and in this process a stump neuroma will form, which is often more painful than the original neuroma.

Are there any alternatives that you can recommend (surgical or non-surgical)? I would love to continue mountain hicking while I am still in good physical condition.

Dear Samuel,

This Orthopedic Chicago Podiatrist located in West Loop 60661,Roscoe Village 60618, Elmhurst 60126 & Bartlett 60103 says...
You may not have a neuroma.You may have an irritation of the joint(s)-known as metatarsalgia- near the nerve. Did the traumatologist reproduce the exact pain of a shooting sensation radiating between the toes- Mulder's sign. Did he check the sensation between the toes? A neuroma has neurologic findings. Ask him about them. An MRI can be mis-read as a neuroma.
An in depth hands on exam is better than any test, with a physician who has experience. An ultrasound may be better-since the doctor performing can do live & manipulate the foot and probe to aid in diagnosis.
Go see someone else for an opinion-Seek an orthopedic foot specialist.
The stump neuroma is usually due to poor surgical technique-not all surgeons are great surgeons. You won't need to worry if you can find a Board Certified Podiatrist.po
Hope this Helps & Good Luck!
The Chicago Podiatrists of are specialists in orthopedics and sports medicine.
We are located in Chicago & Elmhurst

Dr George Tsatsos & Svetlana Zats
Podiatrist Chicago 60618 & Elmhurst 60126 Podiatrists
Board Certified in Foot and Ankle Surgery & Orthopedics
New South Loop Location-Chicago 60661

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Dr George Tsatsos


All questions related to surgery, orthopedics and medicine of the foot and ankle-Adults and Children. Second Opinion specialist in Foot and Ankle problems including fractures and revision surgery. All questions relating. to foot and ankle problems in children Sports medicine of the foot and ankle Runner's and walking problems


PRIVATE PRACTICES: Ankle N Foot, 2220 W Belmont Ave., Chgo., IL 60618 since 1979 Ankle & Foot Center of Elmhurst, 401 N.York Rd., Elmhurst, IL, 60126, since 1989. Physicians Suites, Bethany Hospital, 3435 W. Van Buren, Chgo., Il, 60624, 1980-201. HOSPITAL & SURGICAL AFFILIATIONS: Bethany Hospital, 3435 W. Van Buren, Chgo., Il.- Podiatry staff since 1979-2010 Glen Oaks Medical Center, 701 Winthrop, Glen Dale Hts, IL – Podiatry staff since 1997. Elmhurst Medsurge, 401 N. York Rd., Elmhurst, IL, 60126, since 1999 Resurrection Health Care Surgery Center, 3101 N. Harlem Ave., Chicago, IL, since 1999 Chicago Neurologic & Orthopedic Hospital, 4501 N. Winchester Ave., Chicago, IL, 2008-2010

Member of the National & Midwest Academy of Ambulatory Foot Surgery. Member of American College of Sports Medicine. Member of American Medical Athletic Association. Member of Chicago Metropolitan Ski Council.

Prolotherapy in the Treatment of Foot Problems Clinical Correspondence, June 2002. Vol 92- no. 6 Journal of the American Podiatric Medical Association. Paper on Treatment of Delta-Phalanx of the Foot – submitted for publication to Journal of Foot and Ankle Surgery & for Fellowship of ACPPS., September, 1998 Sports Medicine Consultant for the book-Triathlon 101 Essentials for Multisport Success by John Mora – 1999 ISBN 0-88011-811-3 Windy City Sports – October 1996 Marathon Issue “Keeping Your Feet Happy” American Running & Fitness Association, Clinic Advisor & Lifetime Member – Editorial Staff since 1990.

Fellow-American College of Foot & Ankle Orthopedists, since 1991. Fellow-Academy of Ambulatory Foot Surgery, since 1980. Fellow- American Institute of Foot Medicine , since 1987. Fellow-American College of Foot & Ankle Pediatrics, since 1998. Certified in Laser Surgery- by Wenske Laser Center, Ravenswood Hospital, 1991. Certified in Foot and Ankle Arthroscopy – by Doctor’s Hospital, 1991. Certified Preceptorship Director-Scholl College of Podiatry 1993-2006 Board Certified in Foot & Ankle Surgery-A.B.M.S.P., since 1987. Recertified 8/08 till 3/31/2012 Board Certified in Podiatric Foot & Ankle Orthopedics-A.B.P.O.P.P.M., 1991. Recertified 10/2003 till 12/2013 Board Certified in Pain Management-A.A.P.M., since 1990.-retired Clinical Instructor – Department of Medicine at Rosalind Franklin University 10/2007 until present

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