You shouldn’t have to stop walking the beach, give up your morning run, or wince with every step. Dr. Kevin Lam has treated Morton’s neuroma over a thousand times — including in his own family. Relief is possible. Surgery is often not required.
Radiofrequency ablation procedures performed by Dr. Lam
Of neuroma excision surgeries result in painful complications
Reason for visits — neuroma is one of the most common foot conditions we treat
That nagging pain in the ball of your foot that you’ve been pushing through? It won’t get better on its own. Without treatment, Morton’s neuroma gets worse — and the window for non-surgical solutions can close.
Here in Southwest Florida, life revolves around being active — mornings on the beach in Naples, rounds of golf in Marco Island, fitness walks, family outings. Morton’s neuroma doesn’t just hurt. It systematically takes those things away from you, one activity at a time.
Sharp, electric, or burning pain in the ball of the foot — often described as stepping barefoot on a hot coal.
A constant sensation of a marble, pebble, or bunched-up sock under the forefoot that never goes away.
Tingling, shooting pain, or numbness radiating into the third and fourth toes.
Most shoes become unbearable. Normal footwear compresses the nerve and magnifies pain exponentially.
Walking, standing, exercise — each step becomes something to dread rather than enjoy.
Untreated neuromas don’t stabilize — the nerve thickens, the tissue around it hardens, and pain intensifies.
The most important thing to know: A Morton’s neuroma will not resolve on its own. Waiting and hoping is the one approach guaranteed to make your situation worse and your treatment options more limited. The earlier you act, the more we can accomplish without surgery.
Morton’s neuroma is a thickening of the nerve tissue running between the metatarsal bones of the foot — most commonly between the 3rd and 4th toes. As the nerve becomes irritated and compressed, it swells, and surrounding tissue thickens in response.
Diagnosis at Family Foot & Leg Center combines clinical examination, Mulder’s sign testing, and diagnostic ultrasound to visualize the neuroma directly — confirming diagnosis and sizing the lesion to guide the most appropriate treatment plan.
Sharp, burning or shooting pain in the ball of the foot
Tingling or numbness between the 3rd and 4th toes
Sensation of walking on a pebble, marble, or rolled-up sock
Toes spreading or separating spontaneously
Pain that worsens with narrow shoes or high heels
Temporary relief when shoes are removed and the foot is rubbed
A deep ache that worsens after prolonged standing or walking
Symptoms that progressively worsen over weeks or months
If you recognize these symptoms, you’re not imagining it — and you don’t have to just live with it. Call us at (239) 430-3668 to schedule a comprehensive neuroma evaluation.
During an active gout attack, the treatment goal is reducing pain and inflammation — not lowering uric acid. Here is a summary of evidence-based first-line treatment options your podiatrist or physician may recommend:
| Treatment | How It Works | Best Used When | Timing |
|---|---|---|---|
| NSAIDs Indomethacin, Naproxen |
Block COX enzymes to reduce prostaglandin-driven inflammation and joint pain | No kidney disease, GI issues, or blood-thinning medication conflicts | As early as possible |
| Colchicine | Inhibits neutrophil migration and NLRP3 inflammasome activation — disrupts the crystal-triggered cascade | Within the first 24 hours of symptom onset for maximum efficacy | First 24 hours |
| Corticosteroids Oral, IM, or Intra-articular |
Broad anti-inflammatory via glucocorticoid receptor pathway; intra-articular injections target a single affected joint | When NSAIDs and colchicine are contraindicated; severe monoarticular flares | Alternative option |
| Urate-Lowering Therapy Allopurinol, Febuxostat |
Reduces uric acid synthesis (allopurinol) or excretion; prevents future crystal deposition | After the flare fully resolves — not during an active attack | Post-flare only |
Always consult a licensed healthcare provider before starting or stopping any medication. This table is for informational purposes only and does not constitute medical advice.
At Family Foot & Leg Center, we always start with the least invasive approach. For many patients, a coordinated conservative program delivers lasting relief — no surgery, no downtime.
A precisely targeted corticosteroid injection into the neuroma space reduces inflammation and interrupts the pain cycle. Under ultrasound guidance, medication is delivered directly to the affected nerve tissue for maximum accuracy and effectiveness.
This is often the first intervention we use — and for many patients in the earlier stages of neuroma development, it provides significant and lasting relief. A series of injections may be recommended as part of a broader treatment plan.
A metatarsal pad is a simple but highly effective device placed inside the shoe, just behind the painful area. It works by spreading the metatarsal bones slightly apart, reducing direct compression on the neuroma with every step.
We dispense and fit professional-grade metatarsal pads in the office, correctly positioned for your specific anatomy. Improperly placed pads can actually increase pain — exact placement matters, and our team ensures it's done right.
Off-the-shelf insoles are not adequate for neuromas. We prescribe custom-fabricated orthotics based on a precise biomechanical assessment and casting of your foot. These devices redistribute ground reaction forces across your entire forefoot, reducing pressure through the intermetatarsal space where the neuroma lives.
Custom orthotics also address the underlying biomechanical factors that contributed to neuroma formation in the first place — making them an essential part of preventing recurrence even after successful treatment.
Nerve tissue has specific nutritional needs for healing and optimal function. We recommend NeurX, a doctor-formulated supplement developed by Dr. Lam's own laboratory — DrLamLabs.com — to provide targeted nutritional support to the affected nerve.
Available at DrLamLabs.com • Doctor-formulated • Natural ingredients
Physical therapy is not optional in our neuroma protocol — it is essential. Many practices skip it entirely, which significantly reduces the success rate of every other treatment.
A targeted physical therapy program for neuroma addresses several key factors that injections and orthotics alone cannot:
We coordinate physical therapy as an integral part of your treatment plan — not as an afterthought. Patients who complete a full PT protocol consistently achieve better and longer-lasting results.
Surgical removal of a neuroma — called a neurectomy or excision — sounds like a straightforward solution. It is not. Before any surgeon suggests cutting out your neuroma, you deserve to know the full picture.
Of patients who undergo neuroma excision surgery develop a stump neuroma — a painful growth at the cut end of the severed nerve. This complication can be more painful and harder to treat than the original neuroma, often leaving patients in a worse condition than before surgery.
Published literature on neuroma excision complications →The most feared complication. The cut nerve end forms a hypersensitive painful knob. Occurs in approximately 50% of cases and may require additional treatment — creating a cycle of suffering.
A severe, potentially permanent neurological pain disorder that can develop after nerve surgery. CRPS causes intense, disproportionate, chronic pain — far beyond what any neuroma causes.
When the nerve is removed, sensation in the affected toes is permanently lost. Some patients find this numbness disorienting or uncomfortable — a lifelong consequence of an irreversible procedure.
Post-surgical scar tissue can entrap adjacent nerves, and neuroma symptoms can recur even after complete excision — leaving patients facing a second surgery with a more complicated anatomy.
Neuroma excision typically requires weeks of non-weight-bearing, a surgical boot, and months of recovery — with no guarantee the outcome will be better than non-surgical care.
Surgery removes the nerve permanently. It is an irreversible procedure. If complications arise, there is no un-doing what was done. The stakes are simply too high to choose surgery before exhausting every other option.
Dr. Lam has treated hundreds of patients who came to him after failed neuroma surgery at other facilities — runners who could no longer run, patients unable to walk without pain, people whose stump neuromas were more debilitating than their original condition. These cases — which represent a large proportion of his neuroma practice — are preventable.
"You DO NOT want neuroma surgery. It is highly unpredictable, and the results of a failed excision can create a lifetime of disability. Do not fall victim to surgery before you have truly exhausted every other option." — Dr. Kevin Lam, Family Foot & Leg Center
For the small percentage of patients who have exhausted all non-surgical options and do require surgical intervention, Dr. Lam and the Family Foot & Leg Center physicians offer a technique that preserves the nerve rather than destroying it.
Rather than removing the nerve and creating a permanent deficit — with all its associated risks — this specialized procedure takes a fundamentally different approach:
The transverse metatarsal ligament, which acts as the "ceiling" that compresses the nerve during standing and walking, is released. This decompresses the neuroma by eliminating the primary mechanical cause of irritation. The neuroma is then transposed — carefully moved to the middle layer of the foot, between the deep and superficial tissue planes, so that you are no longer walking directly on the injured nerve with every step.
This approach addresses the cause of neuroma pain rather than simply destroying the nerve. The result is pain relief without permanent numbness or the catastrophic risk of stump neuroma formation that comes with excision.
This surgical technique is offered exclusively by Dr. Kevin Lam and the physicians of Family Foot & Leg Center — a meaningful distinction for patients who have been told surgery is their only option.
Understanding what has worked in the past — and why those options are no longer available or insufficient — helps explain why radiofrequency ablation is now the superior choice for patients who don't respond to conservative care.
Sclerosing alcohol injections were clinically effective when administered as a series of 11 weekly injections. However, insurance companies would only cover one injection per six months — far below the 11-injection threshold needed for clinical benefit. This created a situation where the treatment was real, but insurance made it practically inaccessible. The protocol as designed simply cannot be completed under current coverage rules.
Cryosurgery using the CryoPAC system was an outstanding treatment with excellent results — applying precisely controlled extreme cold to the neuroma to interrupt pain nerve conduction. Dr. Kevin Lam was a certified CryoPAC surgeon and treated many patients successfully with this technology. Unfortunately, the company that manufactured and serviced the CryoPAC units has since gone bankrupt in the UK, and replacement parts and disposables are no longer available anywhere in the world. Existing units cannot be maintained, making this treatment permanently unavailable.
What this means for you: Two of the most effective non-surgical neuroma treatments that were once available are now inaccessible — one due to insurance barriers, one due to equipment obsolescence. Radiofrequency ablation (RFA) has emerged as the logical successor: equally effective, performed with modern technology, and available right here in Naples at Family Foot & Leg Center.
Radiofrequency ablation has been used for decades to treat nerve pain in the spine — for lumbar, cervical, and thoracic pain. Dr. Kevin Lam pioneered its application to foot neuromas, and has now performed this procedure over 1,000 times with outstanding results.
It is important to be transparent: RFA for foot and ankle use is not currently covered by insurance, and is not FDA-cleared specifically for neuroma in the foot (though the device itself is FDA-approved as a medical/surgical instrument). It is an elective, cash-pay procedure. But for patients who have exhausted conservative options and want to avoid the very real risks of surgery, it represents the most compelling option available today. Learn more at NeuromaSECRETS.com.
Think of the neuroma as a fire alarm that won't stop going off, even when there's no fire. The nerve has become so damaged and sensitized that it sends constant pain signals to your brain. RFA uses a tiny probe inserted into the neuroma — guided by real-time ultrasound so we know exactly where we are — and applies controlled heat at precisely 90°C. This damages the pain-conducting nerve fibers so they can no longer transmit those false alarm signals. The nerve stops firing. The pain stops.
Local anesthetic is used to numb the nerves at the ankle level, making the entire procedure completely painless. No general anesthesia, no sedation, no IV line required.
A diagnostic ultrasound probe visualizes the neuroma in real time. Dr. Lam can see the exact location, size, and depth of the nerve before placing a single instrument.
A small, thin probe — no larger than a needle — is inserted through the skin directly into the center of the neuroma under ultrasound visualization.
Controlled radiofrequency energy heats the probe tip to precisely 90 degrees Celsius. Two applications are performed, thoroughly treating the affected nerve tissue to interrupt pain signal transmission.
A simple bandage is applied. The patient walks out immediately. No crutches, no boot, no general anesthesia recovery, and no surgical wound to heal.
A second RFA treatment at 1–2 months may be needed depending on response. Physical therapy is required post-procedure to maximize and sustain results. Topical medication supports healing.
No general anesthesia
Local nerve block only — you're awake and comfortable throughout
No surgical incision
A probe, not a scalpel. No wound, no stitches, no scar
Walk out same day
No crutches, no boot, no wheelchair required
No stump neuroma risk
The nerve is treated, not severed — eliminating the #1 surgical complication
Performed 1,000+ times
Dr. Lam is one of the most experienced neuroma RFA specialists in the country
More effective than steroids
Research shows RFA outperforms corticosteroid treatment for refractory neuromas
I have performed radiofrequency ablation for Morton's neuroma over one thousand times. I have seen patients walk in barely able to cross a room, and walk out — and stay out — of pain they had endured for years. But there is one patient whose outcome I think about differently than all the others.
That patient is my mother. She suffered from neuroma pain for many years — pain I watched quietly limit and reshape her life, long before I had the skills to help her. When I became the surgeon and neuroma specialist that I am today, when I had developed the RFA protocol and performed it hundreds of times, I chose that procedure for her. Not surgery. Not injections alone. Radiofrequency ablation. That tells you everything about my confidence in this technique.
— Dr. Kevin Lam, Double Board-Certified Foot & Ankle Surgeon, Family Foot & Leg Center
The following videos from the Family Foot & Leg Center YouTube channel show Dr. Kevin Lam performing radiofrequency ablation and discussing patient outcomes firsthand.
5 Secrets about Neuromas your doctor may not tell you
Don't have neuroma surgery until you see this, what your doctor may not know.
View all neuroma videos on the Family Foot & Leg Center YouTube channel →
Double Board-Certified Foot & Ankle Surgeon | Clinical Director, Family Foot & Leg Center
Dr. Kevin Lam is one of Southwest Florida's most experienced and decorated foot and ankle surgeons, specializing in the non-surgical and surgical management of Morton's neuroma. He has performed radiofrequency ablation for neuroma over 1,000 times — making him among the most experienced practitioners of this technique in the United States.
As founder of the NeuromaSECRETS.com educational platform and formulator of the NeurX nerve supplement, Dr. Lam has dedicated significant professional energy to advancing neuroma care — not just for his patients, but for patients nationally who cannot find adequate guidance or treatment in their own communities. Surgeons from across the U.S. and internationally travel to Family Foot & Leg Center facilities to learn his techniques.
Family Foot & Leg Center has nine convenient locations throughout Collier, Lee, Charlotte, and Sarasota Counties — serving Naples, Marco Island, Bonita Springs, Estero, Fort Myers, Cape Coral, Port Charlotte, and the surrounding communities since 2005.
Will my neuroma go away on its own?
No. Morton's neuromas do not resolve without treatment. The nerve continues to be compressed and irritated with every step, the surrounding tissue thickens progressively, and pain typically worsens over time. Early intervention produces the best outcomes and the widest range of treatment options.
Is radiofrequency ablation covered by insurance?
At this time, RFA for foot neuroma is not recognized by insurance companies as a covered benefit for use in the foot and ankle, and is not specifically FDA-cleared for this indication — though the device itself is FDA-approved as a medical instrument. It is performed as an elective, out-of-pocket procedure. The device is the same technology used for decades in the spine for back and neck pain, where it is recognized and covered. We are happy to discuss fees and financing options during your consultation.
What is a stump neuroma, and how common is it?
When a neuroma is surgically removed (excision/neurectomy), the cut end of the nerve forms a sensitive, painful knob called a stump neuroma. This occurs in approximately 50% of neuroma excision cases and can be more severe and harder to treat than the original condition. Stump neuromas are one of the primary reasons Dr. Lam strongly advocates for non-surgical treatment and, when surgery is unavoidable, recommends decompression and transposition over excision.
What happened to alcohol injections and cryosurgery?
Sclerosing alcohol injections require a series of 11 weekly treatments to be effective — but insurance will only cover one injection per six months, making the full protocol effectively unavailable to most patients. Cryosurgery was highly effective, but the sole manufacturer of the CryoPAC equipment went bankrupt in the UK, and parts and disposables are no longer available anywhere in the world. RFA has emerged as the natural successor to these treatments.
How many RFA treatments will I need?
Most patients are treated once initially, then evaluated 1–2 months later. Depending on the degree of improvement, a second treatment may be performed. Physical therapy is mandatory following RFA to maximize and sustain results. Some patients achieve complete resolution after a single treatment; others require two sessions.
Who is a candidate for RFA?
RFA is most appropriate for patients who have not achieved adequate relief from conservative care (injections, orthotics, physical therapy) but wish to avoid the significant risks of surgical neurectomy. It is also an excellent option for patients who have undergone prior neuroma surgery and developed a stump neuroma. Dr. Lam evaluates each patient individually during a comprehensive examination to determine candidacy.
Does the RFA procedure hurt?
The procedure itself is performed after a thorough ankle nerve block using local anesthetic — so patients feel nothing during the treatment. The nerve block injection itself is briefly uncomfortable, but the radiofrequency ablation portion is completely painless. Patients walk out of the office afterward wearing a simple bandage.
Gout most commonly affects the metatarsophalangeal joint of the big toe (podagra), the midfoot, ankle, and heel — all squarely within a podiatrist’s domain of expertise. At Family Foot & Leg Center, led by Dr. Kevin Lam, DPM, FACFAS, our board-certified podiatrists offer:
Expert clinical assessment of podagra, ankle gout, and midfoot flares — including joint examination, imaging, and discussion of arthrocentesis when indicated.
Direct corticosteroid injection into an acutely inflamed foot or ankle joint for rapid, targeted pain relief — particularly helpful when NSAIDs are contraindicated.
Gout flares can be incapacitating. Our 9 SWFL locations — from Naples to Sarasota — often offer same-day or next-day scheduling for acute joint pain.
Chronic gout can damage joints and tendons over time. We monitor foot health, screen for tophi, and coordinate care with your internist or rheumatologist.
Dr. Kevin Lam, DPM, FACFAS, DABLES, DABPS — Clinical Director of Family Foot & Leg Center — earned his Doctor of Podiatric Medicine with honors from Temple University and completed advanced surgical training at Mount Sinai Medical Center and Jackson Memorial Health in Miami. Recognized among America’s Top Podiatrists, Dr. Lam has served Southwest Florida patients since 2005 from Marco Island to Sarasota.
Yes — this is one of the most common and consequential misunderstandings in gout diagnosis. Up to 30–40% of patients with a confirmed acute gout flare will have normal or even low serum uric acid at the time of the attack. The body's acute-phase inflammatory response can temporarily suppress circulating uric acid levels. A normal result during a flare does not rule out gout. For an accurate baseline, blood should be drawn at least 2 to 4 weeks after the flare has fully resolved.
Generally no. Initiating urate-lowering therapy (such as allopurinol or febuxostat) during an active flare can cause rapid fluctuations in uric acid levels that may prolong your current attack or trigger new flares. ULT is typically started 2 to 4 weeks after the flare resolves. However, if you are already on ULT when a flare begins, you should continue your current dose without adjustment — stopping abruptly can significantly worsen the attack.
Colchicine is generally considered the most effective single agent when started within the first 24 hours of symptom onset. NSAIDs such as indomethacin or naproxen are also highly effective and can be started immediately. For patients who cannot tolerate NSAIDs or colchicine, corticosteroids (oral, intramuscular, or intra-articular injection into the affected joint) are a reliable alternative. Seek care promptly — early treatment produces dramatically better outcomes.
The gold standard is joint fluid aspiration (arthrocentesis) followed by examination under polarized light microscopy to identify needle-shaped, negatively birefringent monosodium urate crystals. Clinical diagnosis based on the classic presentation (severe big toe pain, rapid onset, resolution within days) and elevated uric acid can be used, but the uric acid caveat above means lab results alone are never sufficient to definitively rule gout in or out.
Family Foot & Leg Center, led by Dr. Kevin Lam DPM, FACFAS, offers expert podiatric evaluation and treatment for acute gout across 9 Southwest Florida locations: Downtown Naples, North Naples, Northeast Naples, East Naples, Estero, Fort Myers (Colonial), Cape Coral, Port Charlotte, and Sarasota. Same-day and next-day appointments are frequently available. Book online at naplespodiatrist.com or call (239) 430-3668.
Take the first step. A comprehensive neuroma evaluation with Dr. Kevin Lam or one of the Family Foot & Leg Center physicians is the most important appointment you can make for your feet — and your quality of life.
Family Foot and Leg Center, PA — Podiatrist Naples FL | Foot Surgery | Heel Pain | Bunion Treatment | Diabetic Foot Care | Sports Podiatry | Serving Marco Island, Naples, Bonita Springs, Fort Myers, Cape Coral, Port Charlotte & Sarasota.
Copyright © 2024 Family Foot & Leg center, P.A. All Rights Reserved.
Fax: (239) 692-9436
Tel: 239-430-3668