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The response to the question below was authored by Marc Mitnick DPM

I spoke to you last week about my 3rd toe amputation and a nerve entrapment.

by Jill S.
(Milford,ct)

Well,I went back to the original Podiatrist who did my surgery,and basically I told him about your advice and he said that he wanted more Xrays and an MRI done. I gave him the MRI and report from my @nd opinion.As I told you they both came up showing zitch.Yesterday he injected more cortisone in the spot where my toe used to be. Excruciating pain there. He then said that in a month if this doesn't work then another shot end of April. then perhaps surgery. Today not only in pain but worse pain from shot on top of regular pain. Couldn't sleep a wink last night.Have you heard of Cryogenic surgery? My Dr said I have Stump Neuroms. I have ben online researching both traditional and Cryo surgery . Please give me your advice. Thanks Again- Jill from CT

RESPONSE

Hi Jill,

As I think I had originally suggested to you, a stump neuroma was one of my thoughts. It seems to be the only logical explanation for the amount of pain that you are in.
The fact that the cortisone shot made it worse is neither here nor there in changing my thought.
Cryogenic surgery is a possible treatment option for neuroma. If you go to my article on Morton's neuroma, there is a video of the procedure.
There is a caveat here. Basically, cryosurgery freezes the nerve and thereby deadens the tissue. Because of this I am not sure freezing the nerve will actually reach the part that is embedded in scar tissue.
I think in your last post you had mentioned that you had received alcohol injections which did not help. The same rule would apply here. The injection could did not reach the part of the nerve embedded in scar tissue.
Although, familiar with the concept of cryosurgery, I personally do not perform it as I prefer the denatured alcohol injections as they basically have the same outcome and the injections are a little less invasive.
There probably is no harm in considering cryosurgery because it is relatively noninvasive, but it is my feeling that the only way you are going to end up resolving this issue is through surgery. In this surgery, the entrapped nerve has to be freed up from the scar tissue and then that portion of nerve would have to be excised.

Marc Mitnick DPM
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Mar 27, 2012
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by: Anonymous

Jill..

in reading your symptoms you are describing my husbands nite mare. I so want to help him but just don't know where to go.. After a terrible accident with a lawn mower he ended up having 1/2 his big toe and all 3rd toe amputated. He sounds to me that he has the nerve entrapment as you describe.

Would you be able to recommend the Dr that helped you out? It would be very appreciated. We also live in NJ and I am getting desparate for him.. he gets no sleep whatsoever.. its been since June 2011..

Thank you Jim and Mark
Lori

Mar 22, 2012
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3rd toe
by: jill S

Thank you so much for all of your advice. In searching the web for people dealing with this same issue i can tell you that you are a Knight In shining Armor! If I lived in Jersey I would gladly be your Spokesperson. Hopefully next time you hear from me it will be good news. God Bless,Jill S

Mar 21, 2012
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reply from 3rd toe amputation
by: Jill S

My next question is this. I just had the shot yesterday and am in more pain than I was in before it. The Dr wants to wait another month and do another injection. Basically I am trapped in my house until then and then a repeat of this experience with another shot? Can I call my Dr next week or so and tell him that I am in agony and tell him no more shots and want surgery asap? I feel so helpless. Thanks again, Jill S.

Sure, have the conversation with him and see what he says.

Marc Mitnick DPM

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ADDITIONAL REFERENCES

Mayo Clinic

Johns Hopkins Medicine

MedlinePlus

Arthritis Foundation

University of Rochester Medical Center

Harvard Health

Drugs.com

American Academy of Pediatrics

Penn State Medical Center

National Institutes of Health

Columbia University Department of Rehabilitation

ScienceDirect

Stanford Health Care

Illinois Bone and Joint Institute

Mount Sinai Hospital

Institute for Chronic Pain

University of Florida Health

American Family Physician

Cedars-Sinai

University of Maryland Medical Center

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(location unknown)

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(location unknown)

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(location unknown)

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Unknown location

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Unknown location

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location unknown

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location unknown

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Bre

location unknown

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anonymous

Dr. Mitnick, Thank you, you were 100% correct. The pain finally brought me to the ER. I spent 8 days in the hospital. The Doppler you spoke of was able to show that there was no pulse in that foot. This was an arterial clot that split and traveled throughout my leg. My leg was almost amputated. I am in rough shape but have all my parts intact!! You certainly know what you are talking about. Thank you for taking the time to answer. Yours Truly!

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Seattle, WA

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location unknown

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New Jersey

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location unknown

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location unknown

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Evansville, IA

Dear Marc

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Russ W.

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location unknown

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Jackie

San Diego, CA

Dr. Mitnick, Just want to say thank you so very much for your quick response and very informative reply! After reading what you had to say, I called the doctor's office and was able to get in and see him the same day as my injury. Toe was x-rayed and luckily, it is not broken or fractured. Very badly bruised and will probably lose the toe nail. And although my toe and toe nail are still very black and blue and very sore, they ARE both starting to feel a little better. So again, thank you! I am so very happy that I came across your website. The service you provide is outstanding and immeasurable!

Rivi,

Albany, NY

Thank you so much for all of your advice. In searching the web for people dealing with this same issue i can tell you that you are a Knight In shining Armor! If I lived in Jersey I would gladly be your Spokesperson. Hopefully next time you hear from me it will be good news. God Bless,

Jill S.

location unknown

THANK YOU SO VERY MUCH FOR YOUR TIME AND EFFORTS, YOU ARE SO VERY APPRECIATED. THANK YOU FOR ALL YOU DO.

Jackie

Whichita, KS

thanks again, this site is very helpful.

mark

Boston, MA

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....Keep up what your doing. Your a life saver.

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Colorado

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annielou

Colorado

Wonderful advice

by: Anonymous

This is the best site for foot problem info.

Thank you for this information. This description fits my pain and inflammation behind my 2nd toe perfectly.

by: Max

location unknown

Again, I really appreciate that you responded to my inquiry, and that your mention of Parkinson's helped me to find my way to a diagnosis of this difficult to diagnose disease. Most patients see on average 16 doctors before they are diagnosed. I hope that you can help other people that ask for your expertise in the future.

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Canada

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location unknown

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Wisconsin

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Julie

location unknown

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Renae

North Carolina

Many Thanks Dr Marc!
Thank you for your response. It sounds like a good plan to me. He did not cut the wart out first ...

KG

location unknown

Thanks again doc for having this website and we STILL need qualified Podiatrists in beautiful sunny Tampa Bay (Bradenton) Florida.

Bessie Mae

Florida

Dear Dr. Mitnick, Thank you so very much for taking your time to answer my question. You have greatly relieved my anxiety related to the continual tingly I feel in my feet. I will share your response with my podiatrist next week. God bless you for having this question and answer page on your website! Most gratefully,

Lynne T.

location unknown

Your webpage is excellent, I commend you on sharing your knowledge to the public.

Robert

New Jersey

Thank you. you were more detailed than what others have told me they finally called from the last xrays and my son is now in a cast for 2 weeks he did have a fracture that was not noticeable.

a mom

location unknown

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Melody

Lenoir, NC

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Rustam

Bellevue, WA

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Jodi

location unknown

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I spoke to you last week about my 3rd toe amputation and a nerve entrapment.

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