Morton’s Neuroma Surgery – What You Need To Know

If you think that you might need to have surgery for Morton’s neuroma, then this article is for you!

It will tell you all the details about surgery, including the types of patients who benefit from surgery versus non-surgical treatment and what surgery looks like.

We’ll also discuss what the recovery process is if you have Morton’s neuroma surgery and some risks that come from surgery. By the end, you’ll know all that you need to know about Morton’s neuroma surgery.

What is Morton’s Neuroma?

Medically speaking, a Morton’s neuroma occurs when the tissue that leads to your toes thickens. It can feel like you’re walking on a marble and causes significant pain in the ball of your feet. It’s also called intermetatarsal neuroma.

Morton’s neuroma occurs most often between your third and fourth toes, typically because there has been excessive pressure or trauma to the nerve underneath the ligament that connects your metatarsals (or toe bones). But it can also be between your second and third toes.

While Morton’s neuroma is typically a tumor of the nerve, it’s not really a tumor so there’s no obvious indication like a lump. But you may experience pain in the ball of your foot as well as numbness in your toes.

It’s less common for you to have pain at night, but more common for you to have pain when you’re exercising or wearing shoes. It’s typically especially painful in tight or high-heeled shoes, which is probably why it’s much more common in women than in men.

Do I Need Surgery for Morton’s Neuroma?

If you’re just discovering that you have a Morton’s neuroma, you probably don’t need surgery right away. Instead, you might be able to address the problem with some simple solutions. For over 80 percent of people, non-surgical treatments are effective in relieving pain!

What Non-Surgery Options Should I Try First?

Before you spend a lot of time and money, you might want to try some other treatments first to see if they solve the problem. Obviously, you’ll also want to speak with your doctor to see what he or she recommends.

Change Your Shoes

The simplest (and cheapest) option is to change your shoes. If the problem hasn’t been occurring for a long time, all you might need is a roomier toe box to give your feet the space they need to be able to splay.

So try avoiding high heels or tight shoes for a couple of days and see what happens. If that doesn’t work, consider purchasing a new pair (maybe splurge on that cute pair of shoes?) that provide support in your sole and space in the toe box. There’s a good chance that this treatment will do the trick.

Try Orthotics

If changing your shoes doesn’t work, you still don’t have to try surgery just yet. Consider getting an orthotic to relieve some of the pressure on your feet. You can try either an over-the-counter insole or a custom orthotic.

Either way, the orthotic will help your feet to naturally splay more because it will help to separate the bones. This means that the pressure on your toe bones will decrease and will likely help with your Morton’s neuroma.

Try an Injection

Finally, if shoes and insoles don’t work, you might try an injection of corticosteroid medication. This can assist in reducing inflammation and swelling, which will help you in experiencing less pain.

Some people have had success with acupuncture but it may or may not work for you.

Who Qualifies for Surgery?

If you’ve tried all other treatment options for Morton’s neuroma and nothing has worked, your doctor will likely consider you a candidate for surgery. Be sure to have answers to questions like when the pain predominantly occurs, when it began, what footwear you typically wear, etc.

Your family doctor can give you advice about foot pain, but if you’re going to have surgery, he or she will refer to a podiatrist or a foot surgeon. The more information you can give your doctors, the better equipped they will be to decide if you’re qualified for surgery. 

If you are a smoker, it’s good to quit at least eight weeks prior to surgery because it can impact your ability to recover quickly from a procedure on your Morton’s neuroma.

How is Surgery Performed for Morton’s Neuroma?

There are different ways to perform surgery for Morton’s neuroma. Some are less invasive than others. For example, cold therapy applies extremely cold temperatures to the nerve, which will kill some of your nerve cells. However, Morton’s neuroma probably won’t come back.

Minimal Invasive Surgery

As the name suggests, this won’t be as intensive as a neurectomy. It’s sometimes also called “decompression” surgery, meaning that it’s supposed to relieve pressure on your nerve.

The way the surgery does that, though, is a little gross. It will cut particular areas inside your foot near your nerve. That way your nerve is still intact, but you don’t have as much pressure on it.

Neurectomy

“Neurectomy” comes from Greek, which is common for medical terminology, and literally means cutting of a nerve. And the nerve that the surgeon will be cutting is the one on the ball of your feet.

This surgery is a last-ditch effort when there is chronic pain and nothing else has been successful because it severs or removes the nerve.

What are the Risks of Having Surgery?

As with any surgery, there are risks of having surgery on your Morton’s neuroma. What is most likely is that you’ll deal with swelling, which may last 6-12 months after your surgery. The more you raise your foot immediately after surgery, the less likely this will happen.

You may also deal with infection if your wounds don’t heal properly. Since the incisions are deep inside your foot, it’s more likely for you to get an infection, but it still only happens in about 5% of cases.

Additionally, once you have surgery for your Morton’s neuroma, you will permanently unable to feel the area between your toes; it will always be numb. This shouldn’t be as painful, though, as an untreated Morton’s neuroma.

Finally, in between 10-20% of cases, pain returns for patients who had surgery and they go back to experiencing the intense discomfort that they had before surgery with their Morton’s neuroma. In that case, you may need additional surgery.

How Long is the Hospital Stay Post-Surgery?

Typically, it’s only a one-day procedure performed under a general anesthetic. In most cases, you’ll be able to go home the day of your surgery. However, you will need to keep your foot in a boot and keep the bandages on your foot for around two weeks.

What Does the Recovery Process Look Like Post-Surgery?

This all depends on the person. If your symptoms are very severe, your recovery is going to take longer than someone else who has symptoms that are milder. Similarly, it’s going to take more time to recover from a neurectomy than another less invasive surgery.

The good news is that for most people who have surgery on their Morton’s neuroma, it is successful—typically between 75-85% of people! This is especially true if you have only one Morton’s neuroma, rather than multiple.   

For the first week, you’ll want to make sure that you elevate your foot and don’t put weight on it. Your foot should be raised above the level of your heart as much as possible because this will help in recovery.

You likely won’t be able to return to work until a week after surgery although this probably isn’t true if you work at a job (like a cashier) that requires you to stand on your feet all day.

You may also need crutches, a knee scooter, or some other type of crutches.

Typically, you’ll be able to return to some exercise and other activity within two or three weeks after your surgery. It will take six weeks for you to completely return to your exercise routine, and you may deal with swelling for up to a year.

Final Thoughts

In closing, hopefully, you are able to treat your Morton’s neuroma without needing surgery. However, if you still do need surgery, this article has given you everything that you need to know about it.

The best thing you can do prior to surgery is to be open with your doctor and try all non-surgical treatment options. Once it’s clear that you need surgery and it happens, make sure that you take the necessary time to recover. You’ll be back on your feet very soon!

American Academy of Orthopaedic Surgeons. “Morton’s Neuroma.” Accessed October 21, 2020. https://orthoinfo.aaos.org/en/diseases–conditions/mortons-neuroma

Heidari, Nima, and Thomas Hester. “What Does Morton’s Neuroma Surgery Involve?” Orthopaedic Specialists. Accessed October 21, 2020. https://os.clinic/treatments/foot-ankle/mortons-neuroma-surgery/

Kasparek, Maximilian, and Wolfgang Schneider. “Surgical Treatment of Morton’s Neuroma: Clinical Results After Open Excision.” International Orthopaedics 37, no. 9 (September 2013): 1857-1861. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3764278/

Mayo Clinic. “Morton’s Neuroma.” Accessed October 21, 2020. https://www.mayoclinic.org/diseases-conditions/mortons-neuroma/symptoms-causes/syc-20351935

Nazario, Brunilda. “What is Morton’s Neuroma? What Causes It?” WebMd. Last modified June 15, 2020. https://www.webmd.com/women/mortons-neuroma#3

NHS Foundation Trust. “Morton’s Neuroma.” Accessed October 21, 2020. https://www.guysandstthomas.nhs.uk/resources/patient-information/surgery/orthopaedics/mortons-neuroma.pdf

Soutis, Michael. “Ancient Greek Terminology in Pediatric Surgery: About the Word Meaning.” Journal of Pediatric Surgery 41, no. 7 (July 2006): 1302-1308. https://pubmed.ncbi.nlm.nih.gov/16818068/

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