What are non-surgical options for a neuroma?
In the early presentation of Morton’s neuroma, it may help to change footwear; avoid high heels, narrow or tight shoes and choose shoes with a wide toe box. The goal is to avoid pressure on the nerves in the foot and toes, ideally allowing the bones of the foot to spread out when putting weight on the foot. By relieving pressure on the nerves, in time, it may heal.
Another simple treatment can be to add a metatarsal pad to the shoe. This is a felt or gel insert that is placed just behind (towards the heel) the metatarsal heads (also known as the ball of the foot). This pad can widen the space between the metatarsal heads and change the area seeing the most weight in the forefoot. Changing the forces in the forefoot can offload the inflamed nerve and allow it to heal.
Dr. Haytmanek may also recommend orthotics that relieve pressure on the neuroma or suggest a corticosteroid injection to help relieve inflammation of the nerve. In certain cases, he may discuss alternative therapies.
When the severity of the condition has progressed or non-surgical options have not helped a patient regain their quality of life, Dr. Haytmanek may recommend Neuroma Surgery.
What is the surgery recommended for Morton’s Neuroma and what are the different surgical options?
Neuroma surgery has a high success rate and is often recommended for Morton’s Neuroma. Occasionally, a nerve decompression can be performed, leaving the nerve in its normal location. If the neuroma is larger or the patient has long standing pain, the nerve may need to be removed (neurectomy).
For either approach, an incision can be made on the top of the foot near the space between the toes.
What can you expect from Neuroma Surgery?
An outpatient procedure can be performed with local anesthesia and sedation or general anesthesia. Surgery itself is typically less than an hour. After surgery pain and discomfort can be managed with pain medication and elevation. Most patients are allowed to fully weight bear in a protective, hard soled shoe after surgery. Sutures are removed around two weeks after the surgery and patients are placed back into standard shoe wear. It may take several weeks or months for full recovery, and patients typically have an area of numbness in the forefoot.