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I had surgery 10 weeks ago to remove a neuroma between my 4th and 5th toe. I've given my foot plenty of rest, and the pain continues. My toe is numb and stiff. I still have a lump under my toe and it continues to be an issue. I saw two different doctors. The first doctor told me it wasn't cancer and I would be good to go for the removal of the Neuroma. The second Dr. told me he had no idea and that it could be Cancer. This had me freaked out for over a month. The only reason I didn't go to the other Dr. which seemed to know more was due to scheduling. I would've had to wait 3 months before I had it removed Vs. having it removed the following month. At the time I had Kaiser, which I've dropped because of all the issues. I can't work out, I can't walk too long before I'm having to sit down. Any recommendations? Thank you very much for your time.
Hello and thank you for the question. Answers given are for informational purposes only and are not meant to replace an exam by an in-person.
I am Dr. Sohaib, a practicing Internal Medicine Specialist and i will do my best to help you today.
You need to answer a few questions first which will help me assist you in a better way.
I need certain clarifications.
First, you had neuroma removed 10 weeks ago right?
The symptoms (pain/numbness/lump) still exist right?
And you want to have this removed again (one doctor told you its not cancer and another said he is not sure), Is this the situation?
Yes, 10 weeks. Symptoms have not subsided after day 9 of the surgery. I want to know if this doctor made a mistake during the surgery. It was benign, however he kept telling me it could and couldn't be. The first Dr. knew right away. The Dr. that performed the surgery was very nervous on my 3rd visit. He told me it was normal, that it will be ok and quickly walked out of the room. I'm 6'3 225 lbs a former athelte and this has seriously put a hold on my life. I can't run, and have to sit after walking a short distance.
Thank you very much for the useful information Bryan.
I honestly believe it was benign growth, rather this was not a tumor in fact. These kind of growths are merely thickening of the nerve sheaths and surgery is usually curative in most of the cases, however, complications may occur.
These include persistence of symptoms due to infection and inadequate decompression of the nerve (which leaves the nerve irritable leading to pain/numbness).
Recurrence of the neuroma (stump neuroma) can also develop in less than 10 % of the people after surgery and this presents with all the symptoms one had prior to the surgery.
These kind of situations are sufficient enough for the surgeon to get nervous and frustrated, and the same happened to your doctor.
I can understand this is also very frustrating for you as well, but we have to move forward now from this point. The next step would include an MRI of the foot which will exactly diagnose the current clinical situation with certainty and will also direct further management plan (which can be in the form of repeat surgery).
Until then you should have rest and keep using motrin or aleve for pain control either alone or in combination with tylenol.
Prior to the surgery the surgeon can also take a biopsy or after surgery and removal of the growth can send the specimen to the laboratory for exact pathological diagnosis to make sure that this is nothing serious like a cancer).
So right now, your next step is to get a re-evaluation done discussing all the details i have mentioned with your surgeon.
I would have been worried too if I were at your place, but let me reassure you that this is a treatable condition and carries a good prognosis with appropriate management.
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He didn't remove the whole lump. This was there during the healing process. Had he done the job right, I wouldn't have to go through another surgery. I understand they may grow back, however in my case, it wasn't completely removed. Is the stiff toe normal? I can't bend it at all.
No, the stiff toe is not normal. This should revert back to absolutely normal if the condition is appropriately treated.
Yes he might have done the job right, but no one can predict if the problem can recur or not. I honestly fear that with out re-evaluation we would not be able to define our further steps in management.
If you dont opt for repeat surgery---its your choice, but at least can have biopsy done to make sure there is no cancer (as you suspect and this has been causing great anxiety to you).
There are custom made shoes which you can wear.
Then local techniques like injection sclerotherapy can also help.
Injection of local anesthetics also provide pain relief.
These options can also be used.