Dear Stanley et al.

I have been sitting back reading all this information with a slight smile
on my face. It is sunny and hot in Sydney, 38 degrees.

The classic neuroma is located between the 3/4 th interspace. Has anyone
ever thought why?

Here the vast majority of neuromas (whatever they might be-
pathologically. if anyone knows please let me know, they are like tennis
elbows. The difference is I know what they are) occur. The simple reason
is that it is the junction between the standing and walking foot. That is
the distal junction between the calcaneus, cuboid, and toes 4 and 5 and
the rest of the foot and ankle.

Thus any dysfuction here causes a wear and tear situation and thus the
neuroma is born. Generally due to compression.

I will defy anyone of you to show me a foot that has normal function and
the foot demonstrates a Morton's neuroma. I have yet to see one and I am
still looking.

Manipulation is going to solve nil. Possibly the manipulation will burst
the neuroma and one can claim success if the pain goes, but the only way
is to prove the neuroma pre and post treatment by ultrasound.

I am more humane, I have mine injected under ultrasound guidance with
steroid and local anaesthetic. The success rate is around 95% at one year.
A one year follow up is a reasonable followup time.

Regards,
PAul Conneely
www.musmed.com.au

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