Neuromas - Laser Surgery

Neuromas

Overview

A neuroma is defined as a thickening of nerve tissues that develop on the bottom of the foot. These neuromas create a loss of sensation, and lack of sensitivity to heat and cold, or sometimes pain in the area. In some cases, the development of a neuroma can cause extreme and intense itching on the bottom of the foot. For some individuals, intense pain and swelling of nerves in the case of a Morton's neuroma can also cause extreme and excruciating pain for an individual. In most cases, a neuroma can be treated with laser surgery, and most specifically with carbon dioxide lasers.

A neuroma of the foot is not hard to diagnose, as it is accompanied by numbness in the area, and may also present with pain classified as "burning" in the middle of the foot. For some, shooting pain is also present, and may affect the toes. Many cases involve a flare-up of neuroma symptoms, and then they disappear, only to return again at a later point in time.

A variety of causes are responsible for a neuroma, including any type of compression or irritation to a nerve along the bottom of the foot. Ill-fitting shoes, as well as individuals with foot deformities including flat feet, hammer toes, or bunions may have a higher risk for neuroma development. Repetitive injury irritation is also a common cause.

Nonsurgical Approach to Neuroma Treatment

Nonsurgical approaches to the treatment of neuromas include but are not limited to padding the arch of the foot, which reduces pressure on the nerve and also helps to release and decrease compression when walking. Use of ice packs may also help reduce swelling, and orthotic devices can provide additional support and reduce the amount of pressure and compression on the nerve. Modification of activity to avoid repetitive pressure may also be recommended, as may shoe modifications. Over-the-counter medication including ibuprofen and nonsteroidal anti-inflammatory drugs may help reduce inflammation and pain. In some cases, cortisone injections may also provide relief.

Surgical Indications for Laser Treatment of Neuroma

If nonsurgical methods for relief of pain, irritation, and lack of motion fail, laser surgery may be recommended. Laser surgery is performed through a laser that omits a laser beam.

Cold laser treatment, also known as LLLT (low-level laser therapy) is safe and painless. This technique has been used for over three decades and is a form of light therapy that is commonly used in the treatment of mild to moderate neuromas. A hand-held probe laser flashes a beam of light that is reflected through wavelengths, and the heat stimulates cellular healing.

Carbon dioxide laser treatment has good results in the treatment of Mortan’s neuromas. The lasers literally cuts nerve tissues at a microscopic level and without frayed edges, which helps reduce the risk of recurrence of a future neuroma.

Cryosurgery for Morton’s neuroma is one of the newest technologies with low complications. The technique utilizes medical grade nitrous oxide to create very cold temperatures that are pinpointed onto the neuroma and that destroy the thickened tissues, without affecting surrounding tissues.

The technique utilizes a cryoprobe tipped with an ‘iceball’ that decreases in temperature to up to -67ºC. The cryoprobe literally destroys the vascular damage to the cappilaries that serve the nerve sheath or myelin, effectively eradicating the neuroma. This is an outpatient procedure that takes about 7 minutes. This procedure is not yet readily available.

Who Performs Laser Treatments for Neuromas?

A podiatrist who belongs to the American Board of podiatric surgery, the American Board of them dilatory foot surgery, or the American Academy of pain management, or country specific organizations and associations, or trained to deal with not only a number of podiatry issues, but laser surgery approaches in dealing with those issues.

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