If you are suffering from Morton’s neuroma, then first of all it’s safe to say that you’ve got some bad luck on your hands. Thankfully, there are many treatment options available to you that can help you get rid of your foot pain so that you can once again stand and walk as you always have before.
Causes & Treatments
Morton’s neuroma can be caused by many different kinds of things. Most of the time it’s because you’re not wearing the right kind of shoes. You often see this type of neuroma in people who wear shoes with tapered toe boxes. This creates pressure on your common digital plantar nerve, which then starts to get irritated and swells up to epic proportions. And that’s why you feel like you’ve got a pebble stuck between your toes.
You stand a big chance of developing such a neuroma if you are wearing the wrong shoes while playing high impact sports, such as basketball, tennis, running, etc. Females are 4 times more at risk than males. Also, if you are above the ripe old age of 50, then you stand a greater chance of developing this neuroma as well.
There are plenty of conservative treatments available to treat this painful condition, such as wearing wider shoes for your Morton’s neuroma, getting good insoles to go with them, physical therapy and applying ice packs frequently until the situation calms down.
Morton’s Neuroma Surgery
If conservative treatment therapies do not work, then your last resort will be surgery. In this case, the neuroma will simply be removed. The surgery must be performed by an experienced surgeon. This condition happens to be a fairly tricky one. If this surgery is performed by a bad surgeon, then your foot pain may actually increase. You may even see the neuroma return, which means that in retrospect the surgery was useless.
When a surgeon performs this surgery, a small incision will be made on the top of your foot. We call this the dorsal approach. The incision will be placed between the third and the fourth toe. The surgeon will have to cut your transverse metatarsal ligament, in order to give himself access to the neuroma. He will then proceed to remove the nerve, and thereby the neuroma. The surgeon then proceeds to stitch up the incision and you will be taken to a room where you can recover from your surgery.
Shortly after the surgery, you’ll be able to walk. However, it will take your foot up to 4 weeks to completely recover, so it’s important that you will take it easy for the time being.
Next to the dorsal approach, there is also the plantar approach, which takes place on the ball of the foot. Using the plantar approach, there is less tissue that needs to be dissected by the surgeon in order to get to the neuroma. This does not require the surgeon to cut your transverse metatarsal ligament. This is good news for you, since this will preserve the stability of your foot in the long term.
Recovery, however, will be slower. You will not be able to walk for up to 3 weeks, because that’s how long it will take for the sutures can be removed. After that, it will take up to 6 months for you to recover, which can in some cases even be quite painful.
There is yet another surgical option for your Morton’s neuroma. Some surgeons are of the opinion that the entire offending nerve needs to be removed. When a nerve is removed that was previously a neuroma, there is very little chance of the neuroma ever returning. Removing the nerve does not in any way affect the foot’s natural mechanics, so it also preserves your foot stability. Many surgeons prefer this method and will opt to remove the whole nerve. Some patients, due to personal circumstances, might require a different approach, though.
If you’ve had the dorsal approach applied to your foot, then you can stand and walk on your freshly operated foot, provided that the shoes have hard soles and are loosely fitting. You’ll probably need to get a good pair of shoes especially for your 3 week recovery period, during which the incision has to heal.
If you’ve had the plantar approach applied to your foot, then you cannot afford to bear any weight on the front part of your foot. You can only manage to do that on your heels, otherwise the incision will open up. You will likely require physical therapy in order to make the muscles in your foot and your ankle stronger. The longer you’ve suffered from Morton’s neuroma, the more necessary this becomes.
When Morton’s neuroma is treated surgically, it is usually a very effective treatment. However, it does come with a recovery period and, like with all surgeries, some side effects and risks.
One risk is that you’ll suffer from post surgical pain after your nerve has had surgery performed on it. Up to 35% of people who have had this surgery, have unacceptable levels of phantom pain in their removed nerve. If not the whole nerve was removed, the remains of the nerve might degenerate, causing further pain.
A severed nerve’s stump might also become trapped in between the metatarsal bones, which causes pain. In some cases, it might even cause the neuroma to return. After this, you might require a second surgery, where the stump of the nerve is planted into the musculature of your foot.
Although surgical treatment is highly effective, is not very often performed because of the relatively high risks of complications. Other therapies, that are less invasive, are preferred, due the fact that they are highly effective. Think of cryotherapy or radio frequency ablation.
Side effects of surgery for Morton’s neuroma, are scarring and the risk of developing an infection. If you also happen to be diabetic, then you will have a harder time healing the surgical wound from this procedure.
If the neuroma is completely removed, nerve and all, then you will have a permanent numbness in your forefoot and between your toes. It’s pretty mild, but it’s something you’ll live with for the rest of your life.