Frequently Asked Questions (FAQs)
What type of patients come to the Center for Morton's neuroma?
- We specialize in treating Morton’s neuroma. We have a nearly missionary zeal to try to cure all Morton’s neuromas. To see and hear examples of these types patients go to our testimonials.
- The newly diagnosed Morton’s neuroma. These patients have just been diagnosed with Morton’s neuroma and they want to come to the place that specializes in treating Morton’s neuroma. They have read about the problems associated with steroid injections and the complications from Morton’s neruoma surgery so they just want to come to place that specializes in treating Morton’s neuroma.
- The patient who has suffered from Morton’s neuroma for years and just wants to get back to doing the things that they used to do. They have tried multiple conservative treatments and may also have tried various procedures with no success and they heard about all the complications of Morton’s neuroma surgery so they avoided surgery. They were searching on the web and just happened to stumble across our site. They are the ones that always say “Why didn’t I hear about you guys earlier?”
- The failed Morton’s neuroma surgery. These are the unfortunate folks who have had Morton’s neuroma surgery and are now in even worse pain than before. Frequently, they can hardly stand or even walk. They were often very active before surgery and now cannot bring themselves to think that they may possibly be incapacitated with Morton’s neuroma pain for the rest of their lives. They are the ones that always say “Why didn’t I hear about you guys before I had surgery?” or “I wish I knew about you before I had surgery.”
- The recently retired person who is in a lot of pain and cannot bear to think about spending their retirement without being active. They have worked most of their life and have spent the last few years looking forward to their retirement. Now they cannot bear the thought of spending their retirement in pain and not being able to play tennis or golf.
- Physicians. We get quite a few physicians who hear about us and come for treatment. We have had all sorts of physicians including Cardiac Surgeons, ER Doctors, Radiologists, Internists and Psychiatrists from all over North America. These folks usually call us asking to be seen as soon as possible.
- The professional athlete or dancer. These folks depend on their mobility for their livelihood. We have had a wide range of professionals as patients who depend on their mobility from waitresses to marathoners to dancers. They all have one thing in common: they depend on their mobility for their livelihood.
- The patient with multiple Morton’s neuromas. Along with the post Morton’s neuroma surgery patients, these are the most difficult clinical situations that we face. They will often require multiple ultrasound guided ablation procedures along with ultrasound guided Platelet Rich Plasma injections and may even need stem cell treatments. Treating these technically difficult cases gives all of us a great deal of professional satisfaction.
Why don't you accept insurance payments?
In order to provide you with the specialist care that our dedicated Morton’s neuroma center provides, we operate as a fee for service practice that does not accept any insurance company payments (except Medicare). We are committed to providing personalized care and unparalleled access to a complete range of products and services specifically tailored for patients suffering from Morton’s neuroma.
By not accepting insurance, we optimize the doctor to patient ratio and allow our doctors to spend time with you, without the usual pressure of having to see a lot of patients. Our patients are only seen by our doctors and not by a Nurse Practitioner, Physician Assistant etc.
This allows us to provide the wide range of specialized services and products for our Morton’s neuroma patients. We do this because we believe that Morton’s neuroma is a complex condition. Most Morton’s patients take some time to fully clinically evaluate. We often see patients who have long histories and have had multiple procedures and operations for their Morton’s neuroma before coming to us. In addition, we have our own protocols for Morton’s procedures and these must be done carefully and can take a lot of time.
To make this work for us, we do not accept insurance payments and we limit the number of patients that we can see. Our doctors are all out of network for all insurance companies except Medicare. You can submit an out of network claim to your insurance company.
Can I get a quote for care ahead of time?
Yes, you can call our practice ahead of time for a written quote on any services we provide.
Are you considered in network for any insurance plans?
We are only in network for Medicare. We are out of network for all other insurance networks. That means if you are a medicare patietn we do not accept any insurance for the 20% copay which must be paid our of pocket on the day the service is rendered.
What about Medicare?
We will bill Medicare for the cost of your medical care. However you will be responsible for paying:
- The 20% copay. Even if you have insurance, you will still need to pay the 20% copay out of pocket on the day the service is delivered since we do not accept any insurance payments.
- Some of the services we provide are not covered by Medicare and so you will need to pay the usual and customary price for those services on the day the service is rendered. You will also be required to fill out a Medicare Advanced Beneficiary Notice (ABN) for these services.
Does my local podiatrist offer the same treatments as you?
Most podiatrists are trained in performing Morton’s neuroma surgery. Some do cortisone injections (mostly without ultrasound guidance) and some may do cryoablation or radio frequency ablation.
We do not know of any podiatrist or any place that uses ultrasound guidance and also offers cryoablation, radio frequency ablation and neurolytic ablation procedures for the treatment of Morton’s neuroma and Plantar Fasciitis. In complex situations, we may also use a nerve stimulator to identify the exact location of the nerve.
We specialize in the treatment of Morton’s neuroma and Plantar Fasciitis.
Can you recommend anyone near me?
We do not make any recommendations and we don’t know of anyone else that does what we do.
We specialize in treating Morton’s neuroma and Plantar Fasciitis.
- Consult / Referral Form
- HIPAA Notice of Privacy Practices
- Patient Clinical Intake Form
- Pre Procedure Instructions
Note: The Center for Morton’s Neuroma works together with Complete Pain Care to provide patients with specialized medical services for Morton’s Neuroma. The above forms that reference medical care are provided by Complete Pain Care.
Can I have a consultation with a doctor before I come in?
Yes, we can organize a video or phone consultation for you and one of our staff doctors before you see her. However, it will cost $375 for a 45 minute consultation (either video or phone). We do not accept any insurance or third party payment for a consultation and this fee will need to be paid up front.
We do this because we generally discourage these types of consultations. We discourage consultations before coming in to see us for the following reasons:
- We cannot make a diagnosis remotely. Morton’s neuroma can be a very difficult diagnosis since the symptoms can vary a lot from one patient to another and there are many conditions that may mimic Morton’s neuroma. More importantly, up to 30% of the population have an asymptomatic Morton’s neuroma so just because you have a Morton’s neuroma on your ultrasound or MRI doesn’t mean that your foot pain is due to Morton’s neuroma. (Think of it like an appendix: Everyone has an appendix but just because you have stomach cramps doesn’t mean that you have appendicitis.) We confirm all diagnosis of Morton’s neuroma with an ultrasound guided local anesthetic injection which is considered the gold standard for the diagnosis of Morton’s Neuroma. We cannot do a physical examination or an ultrasound guided local anesthetic injection remotely so it is virtually impossible for us to make a definitive diagnosis remotely.
- Your past history only helps us when we use it as part of a comprehensive evaluation of your foot pain. This evaluation is done as a part of you initial visit and assessment and takes into consideration your past medical history, your past diagnostic tests, your past procedures, a full clinical examination of both of your feet an ultrasound examination of your inter-metatarsal spaces as well as an ultrasound guided local anesthetic injection. We can on cannot draw many conclusions just from your past medical notes or even just from listening to you describe your history. In fact, we really can’t rely on this information in isolation at all.
- We cannot treat you remotely. Our preferred treatment for a Morton’s neuroma is one of our 3 ultrasound guided ablation procedures possibly combined with a Platelet Rich Plasma Infusion. Since these cannot be done remotely, we really cannot help you remotely.
- We do not guarantee any results. You may want to tell us your history or share you tests with us in the hope that we will say: “Yes we can help you.” However, we are dealing with the human body and we cannot predict your outcome. If we prove that you have a Morton’s neuroma or Plantar Fasciitis, it is most likely that we can help you as we help the vast majority of our patients, but we cannot be sure of it and we cannot guarantee any outcome. Having a consultation with our Medical Director and sharing your past tests or past medical history will not make us more likely to definitively say that we can help you.
If you still want a consultation with our one of our doctors before seeing us, please contact email@example.com with your request and we will contact you to organize it. It can be a video or phone consultation.
Can I send in my test results or past medical history?
Yes, you are welcome to fax or post in your test results such as MRI or Ultrasound reports and your past medical history including the procedure notes from any past procedures that you may have had.
However, we will not look at any of these unless you are a current patient. The reasons for this are as follows:
- We cannot make a diagnosis based on your test results or past medical history alone. As a matter of standard protocol, we do not accept any external diagnosis of Morton’s neuroma. Morton’s neuroma symptoms can vary a lot from one patient to another and there are many conditions that may mimic Morton’s neuroma. More importantly up to 30% of the population have an asymptomatic Morton’s neuroma so just because you have a Morton’s neuroma on your ultrasound or MRI doesn’t mean that your foot pain is due to Morton’s neuroma. (Think of it like an appendix: Everyone has an appendix but just because you have stomach cramps doesn’t mean that you have appendicitis.) We confirm all diagnosis of Morton’s neuroma with an ultrasound guided local anesthetic injection which is considered the gold standard for the diagnosis of Morton’s Neuroma.
- You past history only helps us as part of a comprehensive evaluation of your foot pain. This evaluation is done as a part of your initial assessment and takes into consideration your past medical history, your past diagnostic tests, your past procedures, a full clinical examination of both of your feet an ultrasound examination of your inter-metatarsal spaces as well as an ultrasound guided local anesthetic injection. We cannot draw any good conclusions just from reading your past medical notes or looking at your tests in isolation. In fact we really can’t rely on this information in isolation at all. So we don’t, we only use as part of a full clinical assessment.
- Medical liability reasons. See our Medical disclaimer.
You may want to tell us your history or share you tests with us in the hope that we will say: “Yes we can help you.” However, we are dealing with the human body and we cannot predict your outcome. If we prove that you have a Morton’s neuroma or Plantar Fasciitis, it is most likely that we can help you as we help the vast majority of our patients, but we cannot be sure of it and we cannot guarantee any outcome. Sharing your past tests or past medical history will not make us more likely to definitively say that we can help you.
As part of our medical services all patients are seen and treated by oner of our doctors. If you send us your test results or past medical history, we will hold them for you and have them ready to use as part of our doctor’s full clinical assessment of you and your pain.
How many procedures will I need to treat Morton's neuroma?
Most patients require 2 or even 3 ultrasound guided ablations. There are no clear rules as to how many procedures you’ll need to treat your Morton’s neuroma, but here are some guidelines:
- If you have one simple neuroma and have not had any previous procedure done on it, then you will probably need only one procedure but you should still be prepared to come back in case you need another procedure.
- If you have a complex long history or have multiple Morton’s neuromas or already have had Morton’s neuroma surgery before seeing us, then you will almost certainly need a repeat procedure and possibly a few repeat procedures.
We do not have a cookie cutter approach to your care. Morton’s neuroma is difficult to treat, but we specialize in treating Morton’s neuroma and we have a number of solutions. So if you have come and see us and have an ultrasound guided procedure but still have pain, don’t be discouraged. We have a number of ultrasound guided procedures that we can do if one does not produce the results we expect. We will stick by you and work with you to treat your Morton’s neruoma. You may need multiple procedures.
After you have your procedure: We suggest mild activity for the first few days. Don’t try vigorous running or long jogs for at least a couple of weeks. If you are a marathoner, don’t resume your intensive training until about 4 weeks. After that, depending on how your foot feels, you can ease back into it. Although rare, some people may experience soreness for up to 4-6 weeks.
Your next procedure: We wait 6 weeks for the full effect of the procedure before we make a decision with you to do another procedure. If you need a repeat procedure, you can come in and have it done. In general, since you are already a patient of ours, your can come in, have your procedure and travel all on the same day. You do not need to come in for a separate evaluation visit, unless you would like to see us beforehand.
Depending on the results of your first procedure, we may repeat the same procedure or we may do a different ultrasound guided ablation procedure. If your response to our procedure has been below our expectations, we may also recommend a Platelet Rich Plasma injection done under ultrasound guidance in addition to your procedure.
Can I fly in and have my Morton's procedure done on the same day?
New patients must come in for an initial assessment. Based on the clinical findings and our physician’s assessment, a treatment plan is created together with the patient. In nearly all cases we perform a diagnostic injection with the initial visit. If you come from out of town, your Morton’s ablation procedure can then be performed on that same day. We ask that patients wait at least 24 hours before traveling back home.
If the patient is recently known to us, we can do the procedure the same day without an initial assessment.
How long will it take to recover from my procedure?
Patients can travel after waiting 24 hours after their procedure. Usually, they usually can return to work after 48 hours, if their work does not involve a lot of standing and walking.
We suggest mild activity for the first few days and then ease back into your routine over a couple of weeks. Nothing with high impact to the bottom of your foot, such as jumping or long distance running for 6 to 8 weeks.
Although rare, some people may experience soreness for up to 4-6 weeks.
Can an ablation procedure cause a stump neuroma?
No. An ablation procedure cannot cause a stump neuroma. A stump neuroma is caused by the body’s normal response to a cut nerve. This response is call a Wallerian degeneration. Nearly all Morton’s neuroma surgeries result in a cut nerve and therefore a stump neuroma is a very real complication.
An ablation procedure does not cut the nerve. Instead, it kills the nerve while leaving the nerve sheath and nerve fibers intact. This difference is key and is the reason why the body does not have a true Wallerian reaction to an ablation procedure and therefore a stump neuroma cannot occur.
For more information about this and about Wallerian degeneration in Morton’s neuroma procedures Click here.
Should I have surgery for my Morton's neuroma?
See our blog article for a discussion of whether you should have surgery for your Morton’s neuroma – Click here