Does Morton's Neuroma Surgery Work?
One of the most common causes of forefoot pain is a Morton’s Neuroma . This is a benign thickening or swelling of a nerve just in front of the toes. A Morton’s Neuroma is most frequently found between the third and fourth toes but can also be in between the second and third toes.
Symptoms of Morton's Neuroma
Pain in the ball of the foot as well as burning, tingling and numbness are common symptoms of a Morton’s Neuroma. The discomfort is usually localized but can radiate among multiple toes.
Non-surgical Treatment of Morton's Neuroma
Most patients obtain satisfactory results with non-surgical treatments . This includes pads, cushions, shoe changes, medications and injections. Occasionally, physical therapy and immobilization in a walking boot are effective.
Morton's Neuroma Surgery
When non-surgical treatments fail, a procedure call a neurectomy can be performed . Neurectomy involves the surgical excision of the painful Morton’s Neuroma. This can be performed through an incision on either the top (dorsal incision) or bottom (plantar incision) of the foot. Each technique has it advantages and rationale for selection.
Results of Morton's Neuroma Surgery
85% of patients undergoing neurectomy report good to excellent results. Patients with Morton’s Neuromas in both feet or with multiple neuromas in one foot report worse outcomes.
Complications of Morton's Neuroma Surgery
Complications following Morton’s Neuroma surgery are relatively rare:
- Infection can occur as with any surgical procedure.
- Regrowth or recurrence of the neuroma occurs infrequently.
- The most common complication of the dorsal incision approach is called a “stump” neuroma. Because it is harder to access the Morton’s Neuroma from the top of the foot a smaller portion of the neuroma is excised. Sometimes the end of the nerve develops a lump of scar tissue called a “stump” neuroma. This is less common with the plantar incision approach because it is easier to access the Morton’s Neuroma from the bottom of the foot.
- Painful scar is a concern with the plantar incision because the incision is placed on the bottom of the foot. The rate of painful scar is around 3 to 5% with this incision.
