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Posts for: September, 2014

Morton's neuroma is a common diagnosis that we see in our practice. A neuroma in the foot presents most commonly with pain in between the third and fourth toes with pain in the ball of the foot. Pain is usually burning, tingling, and shooting pain that radiates into the third and fourth toes and sometimes into the 2nd and 3rd toes. A neuroma usually feels like a sock rolled up in the shoe and feels better upon taking off the shoe and sock. We most commonly see neuromas in women that wear high heel shoes which places much force on the ball of the foot which can irritate the nerve. Neuromas develop over time as well when the fat padding on the ball of the foot reduces as we age.

Dr. Brown and Dr. Saffer practice philosophy has changed over the years regarding the treatment of neuromas. At the most recent American College of Foot and Ankle Surgeons lecturers this year support more conservative treatment for neuromas versus surgical excision as in years past. The one dreaded complication of neuroma surgery is a "stump neuroma" which is a regrowth of the nerve which can cause painful symptoms.

Dr. Brown and Dr. Saffer have had much success with conservative treatment with eventual resolution of neuroma symptoms. Conservative tx options that our practice follows are: NSAIDS, ice, offloading with pads and Orthotics, cortisone injections (max three per year), and the more state of the art treatment alcohol sclerosing agent injections. These type of injections deaden the nerve and reduced symptoms and up to six to seven injections if needed per year can be given. This type of treatment has really helped our patient population that has either suffered through complications of previous surgery or who have not had relief with other conventional treatments. Cryotherapy which is freezing of the nerve is another option as well. Surgical excision is typically the last option for our patients.

Dr. Saffer has suffered from a neuroma several years ago and had relief and resolution with conservative treatment. It is also very important to know if you have pain on the ball of the foot it is not always a neuroma. It could be bursitis, capsulitis, stress fracture, or arthritis. Please refer to our website for more information on neuromas.


Do you or your children participate in Martial arts and have foot pain? If so this is not uncommon due to the stresses involved going barefoot while running and kicking objects such as bags and boards. We would like to have you refer to a nice article on foot injuries associated with martial arts and give advice in the next few blogs on prevention and treatment of various foot injuries in martial arts. If you have any foot injuries that are longer than 3-5 days please give our offices a call or refer to our website for further information at

Below is the link from Podiatry today.

Are you training for an upcoming triathlon? Do you have foot or ankle pain that is not allowing you to train? Our Podiatric Sports Medicine Colleague Dr. Marybeth Crane out of Texas has a nice article that you should read that discussed triathlons and common foot injuries. Please refer below to the link in Podiatry Today.

Are you training for the upcoming Charleston Marathon or 1/2 Marathon? If so and you are having any foot pain that is hindering your training please gives us a call. Dr. Saffer and Dr. Brown both are runners and know what it feels like to have foot pain. Dr. Saffer and Dr. Brown work with runners to correctly diagnose the specific foot complaint and work to heal the foot while still keeping active.

Do you have heel pain? If so it may not always be "Plantar Fasciitis". The wrong diagnosis can delay your recovery. Heel pain can present in different ways such as a stress fracture, nerve injury, bone tumor, plantar fasciitis, growth plate injury in children, and plantar fasciosis (chronic plantar fascia injury). Dr. Saffer and Dr. Brown have state of the art diagnostic ultrasound and digital x-ray in each office. Both foot specialists are trained Sports Podiatrist and foot surgeons who have a passion for athletics. Dr. Saffer and Dr. Brown exhaust all conservative treatment for heel pain and very rarely have to perform surgery for heel pain. Two minimally invasive surgeries for chronic plantar fasciitis are Topaz and the Instep plantar fasciotomy. Each procedure has minimal down time.

Please refer to our website home page for more information on various forms of heel pain at