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TTS Surgery successes?

Posted by Michaeld on 7/03/03 at 14:41 (123518)

I have been diagnosed with TTS and Morton's Neuroma between my second and third toe. I know how I came to have this condition. I went from basically a desk job for 30 years to building out a business site of my own. This work was on a large concrete slab doing a few weeks of squating and kneeling often time barefoot. Not knowing that this was causing damage to my feet until a few weeks into it. My pain started in the balls of both feet. I didn't go see a Dr. right away, thinking that it would get better. To make a long story short, both feet have similar discomfort, the right one is slightly worse than the left.
I had an ultra-sound on the right foot and ankle which indicated the neuroma and also a 50% compression of the nerve in the tarsal tunnel. I am currently scheduled for surgery to address both problems in the right foot first.

My symptoms are consistent with the neuroma but it feels like I have multiple neuromas as the majority of the ball of my feet have discomfort. I also have cramping and discomfort along the arch of my feet with burning and numbing in the area of my toes. Last week I had a test (I don't recall ths name of the test) with pressure probes that tested for my ability to feel the probes pressing on different areas of my foot. This test also indicated TTS along with some other terms.

I would like to hear some success stories on this kind of surgery. I'm reading of some pretty lengthy recovery times, and nobody seems to be saying the surgery was very successful. I know there are many variables, but I'm wondering if the TTS surgery may be the cure without doing the Neuroma surgery. Has anybody out there had both procedures at the same time? Thanks...

Re: TTS Surgery successes?

cindyp on 7/03/03 at 18:36 (123532)

I have repeatedly said mine was successful. Get a competent dr. and exhaust every other possibility before choosing surgery. Get a good podiatrist and a good foot and ankle orthopedist.

Re: TTS Surgery successes?

Ed Davis, DPM on 7/04/03 at 11:32 (123577)

If a neuroma is present, removing it is a relatively minor procedure compared to TTS surgery. The feeling of having multiple neuromas in the forefoot is common with TTS and, at times, has led to incorrect diagnoses where surgeons looked for the neuromas without success. It sounds like your doc knows his/her stuff. Surgery for tarsal tunnel syndrome is not technically complex nor is it a 'big' procedure but the recovery time can be lengthy and the success rate only about 2/3. A trial of conservative treatment is reasonable but one should not wait too long for surgery as the success rate is lower for TTS that has persisted for longer periods of time.

Re: TTS Surgery successes?

chrisb on 7/05/03 at 13:40 (123627)

You say ultrasound showed 50% compression of the nerve in the tarsal tunnel. I didn't realise ultrasound could show nerve problems. My ultrasound only measured the thickness of the fascia. Did you have a different type of diagnostic ultrasound?

Re: TTS Surgery successes?

Ed Davis, DPM on 7/06/03 at 12:31 (123657)


Good question since ultrasound techniques generally cannot lead to such a specific diagnosis. Ultrasound has the potential to show enlarged structures or perhaps an excess of scar tissue in the tarsal tunnel but I have never seen it used to draw such a specific conclusion. I would be curious as to how the doctor reached that conclusion.

Re: TTS Surgery successes?

Michaeld on 7/07/03 at 15:52 (123710)

Dr. Davis, thanks for your input.
I have had this condition for over three years. The diagnosis has proceeded from Metatarsalgia initially, to Neuroma, then to additionally TTS. I really don't question the diagnosis so much as the merit of the surgery.
The ultra sound was recommended by my DPM, and was done by a radiologist that he very highly recommended. You know better than I what can be determined by ultrasound. I was told that I had severe deterioration of the lower part of the toe bones where they join with the matatarsals (forgive my ignorance of correct terminology). There was even small fragments of bone detected in that vicinity. Yes I was told that the neuroma was 10 millimeters if I'm not mistaken, and the nerve compression is 50%, which I guess would account for a significant loss of senitivity and probably pain in the forward half of my foot.

In your other note you you mentioned a trial conservative treatment. I had a total of 4 steroid injections between my 2nd & 3rd, and 3rd & 4th toes. I was very hopeful that these were going to cure the condition. But relief was only temporary.

The last test procedure I had was employing a pressure sensitive dual probe that determined my sensitivity to feeling the probes and how far apart they were before I could sense two probes. That was done on the bottom of my great toe, then on the web area on top and between my 1st & 2nd toe, then on the ball at the base of the great toe. It clearly printed out TTS, and some other conditions as well. The bottom of the great toe never did sense both probes, only general pressure. Are you familiar with that test. I was given that test by an interested DPM that is doing a paper on that test procedure. He wants a before and after test.

Would it be strongly advised to seek a second opinion. It's not that I have no confidence in my DPM, I'm concerned with the revoery time and apparent potential lack of success.

Thanks, Michael

Re: TTS Surgery successes?

Michaeld on 7/07/03 at 16:06 (123712)

Chris, thanks for your input. I don't know that much about the ultrasound procedure that I had. It was highly recommended by my DPM, and was conducted by a radiologist that he highly recommended. I couldn't tell you much more than what I was told. He detected a 10 millimeter neuroma if I'm not mistaken, and a 50% compression of the nerve in the tarsal tunnel.

I have really become concerned as a result of my running across an Orthpedic Surgeon that I knew from a prior elbow problem. I told him about the TTS diagnosis and he looked at me very suspiciously and said that those are extremely rare and that he had only seen two cases in his 20 some years as a Ortho Surgeon, and both of those were results of a serious physical injury.

Did you have TTS surgery, and if so what was the recovery time and success?
I have a major Italy vacation planned in Late October. I'm hoping to be relatively ambulatory by that time. It sounds like a good chance of that being ambitious. Also, I sure would like to hear that this surgery and pain and agony will be somewhat successful.

Thanks for you comments, Michael

Re: TTS Surgery successes?

Missy B on 7/07/03 at 18:17 (123717)

Michaeld: I had TT release surgery 18 months ago, and I can truthfully say that I have 90% improvement over my former pain - and many days are almost totally pain free.
The only advice I can give is what I did myself: I found a good podiatric surgeon who had performed this surgery several times before with good to excellent results. Only after he tried all the non-invasive treatments on me for many months ( they did not give me relief), did he ask me if I wanted to consider surgery. My doctor was very conservative and I was off my job for 9 weeks recovery because I work in a hospital and am on my feet 90% of my shift. I spent the first 5 weeks after surgery almost non-weight bearing on my foot, then slowly began wearing shoes and increasing my daily activity until I was able to return to work. I also underwent 4 weeks of physical therapy on the foot. And for the next several months after I returned to work, I limited the amount of time I spent on my feet, trying to rest with my feet up several hours every evening. Today I am not only able to put in a full days work on my feet, but also enjoy many outside activities with no or minimal discomfort. Will I ever run a marathon or hike 15 miles up a mountain - No. But I can walk up to 5 miles every day for exercise, enjoy horseback riding, and work out at the gym. And I am grateful because before my surgery, there were days I would come home in tears because of the pain and drag my leg rather then step down on my foot.
Good luck to you if you decide on surgery and please (1) follow your doctor's instructions carefully, and (2) do not rush your recovery - the health of your feet in years to come may depend on taking 'time off' now.
Missy B.