Luxe Foot Surgery Logo

Morton’s Neuroma Surgery

Welcome to Luxe Foot Surgery, your trusted clinic for Morton’s Neuroma Surgery in Miami. We’re committed to delivering effective treatments for challenging foot conditions like Morton’s Neuroma, alleviating pain and enhancing mobility. In this article, we’ll outline everything you need to know about this specific procedure, covering all aspects of Morton’s Neuroma Surgery at our Miami clinic.

AVERAGE COST

$5000 - 7000

PROCEDURE TIME

30 – 40 Min

BACK TO WORK

2 - 3 week

FULL RECOVERY

3 - 6 months

Book Your Free Consultation

Woman taking off her high heels shoes with foot pain after a long day_Morton's Neuroma Surgery - Luxe Foot Surgery Center

What is a Morton's neuroma?

Morton’s neuroma is considered a pathology, more precisely a compressive neuropathy, which appears in the metatarsal area, and which is characterized by causing a lot of pain. The name “Morton’s neuroma” is due to the fact that it was the English surgeon Thomas G. Morton who, for the first time, described several cases of his patients with neuroma, in the year 1876. Morton also performed the first surgical procedures to cure the neuroma that bears his name. This disorder is also known as:

  • Morton’s metatarsalgia (since it is considered one of the causes of metatarsalgia).
  • Interdigital neuroma.
  • Plantar neuroma.

From a clinical point of view, Morton’s neuroma consists of degeneration of the plantar digital nerve, followed by fibrosis (inflammation or thickening) of the tissue around it. In most cases, Morton’s neuroma is caused by compression of the nerves near the metatarsal bones, resulting in inflammation and swelling.

Morton’s neuroma produces a sharp shooting or burning pain that covers the metatarsal, so it can be considered a type of metatarsalgia. The pain can also spread to the toes, and can even cover the entire foot and go up the leg. Sufferers of this condition only find temporary relief when they sit up and remove their shoes. Once the stress stimulus on the foot is removed, the pain and discomfort quickly disappear.

Morton's neuroma anatomy

What is a Morton's neuroma

Morton’s neuroma is a condition that affects the nerves in the foot. The nerves involved are the plantar common digital nerves, which branch off from the main nerve, known as the medial plantar nerve. When these nerves get compressed by the metatarsal bones in the foot, they become trapped, leading to Morton’s neuroma. This compression causes material to accumulate inside the nerve, which can cause nerve damage.

Morton’s neuroma usually appears between the third and fourth metatarsals in about 75% of cases. This is because the third space is the narrowest, making it easier for the nerves to get trapped. In the third space, there is also an interconnection between the lateral and medial plantar nerve branches, which causes the nerve to have a larger diameter, increasing the risk for compression. Understanding the anatomy of Morton’s neuroma is crucial for its diagnosis and treatment.

Morton's neuroma symptoms

Among the most common symptoms of Morton’s neuroma we have the following:

  • Feeling a sharp pain between the toes.
  • Burning sensation when supporting the foot when walking or standing.
  • Having visible swelling between the toes.
  • Numbness and tingling in the toes.
  • Sensation of pain and swelling in the area of the “ball of the foot” (the lower area of the metatarsus).
  • Discomfort when walking, as if there was a stone stuck in the foot.
  • Feeling more pain when walking than when at rest.
  • Pain may be experienced as spreading along the foot or up the leg, which is alleviated by walking barefoot.

What is Morton's neuroma surgery?

Morton’s neuroma surgery is typically an outpatient procedure, meaning that most patients can leave the hospital on the same day as the surgery as long as there are no complications. The surgery typically involves removing the affected nerve from the ball of the foot through a 2 cm incision, usually made in the upper part of the foot but sometimes made below. This allows the surgeon to access the neuroma and remove it.

It is essential to remove the nerve correctly to prevent any residual part from generating pain due to compression. In some cases, a different type of neuroma surgery may be performed where the nerve is not removed. After the incision is closed with sutures or stitches, the foot is bandaged and remains so until it is time to remove the stitches.

Recovery time can vary depending on the extent of the surgery, but most patients can expect to return to normal activities within a few weeks after the procedure. It is important to follow the post-operative instructions provided by the surgeon to ensure a successful recovery.

06 Team of surgeons at work in operation theatre surrounding patient on operation table Mortons Neuroma Surgery Luxe Foot Surgery Center

Types of Morton's Neuroma Surgery

There are two main types or groups of surgical techniques for Morton’s neuroma. The first group involves surgeries aimed at removing the neuroma, while the second group involves surgeries aimed at directly treating the underlying cause of the neuroma, such as metatarsalgia or releasing a tight ligament. Here is a brief description of each group:

  1. Morton’s Neuroma Surgery with Excision: This involves cutting the nerves in the ball of the foot area around where the neuroma is located, resulting in the removal of the neuroma. The procedure, known as a neurectomy, involves making a small incision on the top or bottom of the foot.

  2. Morton’s Neuroma Surgery Focused on the Cause: In some cases, Morton’s neuroma surgery involves releasing the tight ligament that is covering the nerve, without removing the nerve itself. However, opinions among specialists are divided regarding the effectiveness of this type of surgery, as some believe that neurectomy is necessary for effective treatment.

The most appropriate surgical technique for each patient should be evaluated based on the particular conditions of their condition. Recovery time and post-operative care will depend on the extent of the surgery performed. It is essential to follow the post-operative instructions provided by the surgeon to ensure proper healing and recovery.

Concept of costs calculation, Calculator. Three-dimensional image.

Morton's Neuroma Surgery Cost in Miami

The cost of Morton’s Neuroma Surgery in Miami typically ranges from $3500 to $4500. This price reflects various aspects of the procedure, including surgeon’s fees, use of the surgical facility, anesthesia, and follow-up care. Each case may vary depending on its complexity and the specific healthcare provider.

08 Man's leg uses crutches to walk after surgery recovery_Morton's Neuroma Surgery - Luxe Foot Surgery Center

Recovery after neuroma surgery

Morton’s neuroma surgery is a common procedure used to treat neuroma, a condition where the tissue surrounding the nerves that lead to the toes thickens and causes pain. After the surgery, patients must go through a recovery period to ensure the success of the procedure. Here are some tips to achieve a correct recovery after neuroma surgery.

The First Day of Recovery

After the surgery, the foot will be bandaged and immobilized. Patients will feel a numb sensation without pain until the anesthesia wears off. It is essential to avoid putting weight on the foot to walk. A physical therapist will teach the patient how to walk without supporting the foot, use rigid and padded surgical shoes, and crutches. An analgesic plan will be prescribed to manage pain. It is best to avoid bathing on the first day after surgery and keep the foot elevated and rested.

First Two Weeks of Recovery

The pain will be mild to moderate in intensity during the first postoperative days. Patients may feel some numbness in the operated foot, as well as swelling. To avoid inflammation, it is recommended to keep the foot elevated for as long as possible. When showering, use a waterproof bag to prevent the foot bandage from getting wet.

Patients can begin to move the toes as the pain allows. If you notice any drainage from the bandage, it is normal, and it is better not to touch the bandage. Between the 10th and 15th day, the first post-surgical appointment with the surgeon will take place to remove the stitches or sutures. From that moment, the wound can be washed in the bath in the normal way, and the person can start walking with common shoes that have soft soles. It will be normal to perceive some inflammation at the end of the day.

From the Third to the Sixth Week of Recovery

After the fourth week of recovery, patients who had the operation on their right foot can drive normally again. Patients can wear normal shoes, as long as they fit comfortably. Avoid wearing high heels or tight shoes. The foot may continue to swell towards the end of the day or when carrying too much weight. Patients should attend another review appointment with the surgeon in the fourth week of recovery. Avoid playing sports, but those with a sedentary job may return to work.

From the Second to the Third Month of Recovery

In this period, the foot should be much stronger, and patients will feel more like normal. Patients can begin to incorporate the practice of sports if the surgeon deems it appropriate.

Sixth Month of Recovery

After 6 months of recovery, patients must attend the last follow-up appointment with the surgeon. At that time, a final review of the foot will be carried out, and if everything is in good condition, the patient will be discharged. By this time, patients should be enjoying all the benefits of Morton’s neuroma surgery, although some swelling is still normal.

After the First Year of Recovery

After the first year of recovery from Morton’s neuroma surgery, patients are expected to be well and able to perform any type of physical activity without problems, including sports and strenuous exercise. By this time, the foot swelling should have disappeared or decreased noticeably.

Elderly woman swollen feet putting on shoes with care giver_Morton's Neuroma Surgery - Luxe Foot Surgery Center

Causes of Morton's neuroma

Although ultimately the cause of Morton’s neuroma is still unknown, some etiological hypotheses have been raised for this condition. The general causes of the appearance of Morton’s neuroma can be grouped into 4 groups:

  1. Chronic Trauma: The chronic microtraumas that result from walking or excessive use of the foot can cause the intermetatarsal plantar digital nerves to become trapped between two metatarsal heads and their respective metatarsophalangeal joints. This type of trauma is typically observed between the third and fourth metatarsal bones.

  2. Nerve Compression or Entrapment: Compression of the interdigital nerve against the anterior end of the deep transverse metatarsal ligament and the plantar soft tissue structures can lead to the development of Morton’s Neuroma.

  3. Bursitis in the Intermetatarsal Region: Inflammation of the plantar digital nerve is caused by bursitis of the intermetatarsal bursa, which is located close to the neurovascular bundle in the second and third intermetatarsal spaces.

  4. Plantar Digital Artery Ischemia: Degenerative changes in the common plantar digital artery cause fibrous thickening of the nerve and result in ischemia, which is another possible cause of Morton’s Neuroma.

Several habits and conditions can also contribute to the development of Morton’s Neuroma, including:

a) Use of Inappropriate Footwear: Frequent use of shoes with high heels, tight toe boxes, or poor fit can decrease the diameter between the metatarsals, compressing the plantar nerve branches and increasing the risk of Morton’s Neuroma.

b) Heredity and Genetic Factors: Some genetic foot structures inherited from parents increase the likelihood of developing Morton’s Neuroma.

c) Excessive Activity: Participating in high-impact sports that require tight shoes or involve repetitive foot motions, such as running, jogging, tennis, skiing, or mountain climbing, can generate excessive activity on the metatarsal bones, leading to irritation and pressure on the ball of the foot, which can cause compression of the nerves and the development of Morton’s Neuroma.

d) Foot Deformities: Having a foot deformity such as a bunion, flat foot, cavus foot, or hammer toe is another risk factor for Morton’s Neuroma to appear. These deformities cause misalignment of the metatarsal bones, leading to nerve compression and the development of Morton’s Neuroma.

e) Thinning of the Ball of the Foot: When the fat pad at the ball of the foot wears away, the metatarsal bones become more exposed, causing greater pressure on them and compression of the nerves between the plantar fascia and the metatarsals, which can lead to Morton’s Neuroma.

Benefits of Morton's neuroma surgery

Successful Morton’s Neuroma surgery offers many benefits that can improve the patient’s daily life. Some of the main benefits include:

  1. Ability to walk normally without changing body posture.
  2. Elimination of pain and discomfort when supporting the foot.
  3. No more burning sensations in the forefoot.
  4. Ability to perform all daily activities with agility and without discomfort.
  5. Return to exercising and participating in physical activities.
  6. Elimination of the feeling of numbness and tingling in the toes.
  7. Improvement in overall quality of life, marking a before and after surgery.

 

These benefits can greatly enhance the patient’s mobility, comfort, and enjoyment of daily activities. It is important to discuss the potential benefits and risks of Morton’s Neuroma surgery with a qualified surgeon to determine the best treatment option for each patient.

Mid adult orthopedist examining injured foot of young woman during medical appointment_Morton's Neuroma Surgery - Luxe Foot Surgery Center

Risks and possible complications of Morton's neuroma surgery

Morton’s Neuroma surgery is generally considered safe, but like any surgical procedure, it carries some risks and possible complications. Here are some of them:

  1. Skin infection: Infection is a possible complication after surgery. Patients should be alert for any unusual discoloration, itching, or swelling around the incision.

  2. Bone infection: Bone infection is much less likely than skin infection, but it is more serious and dangerous. Another operation may be needed to remove the infected bone, and extensive courses of antibiotics will be required.

  3. Numbness: Patients may experience numbness in the toe or a large part of the foot as a consequence of the nerve removal.

  4. Permanent pain: Some patients may experience permanent or ongoing pain, which may require additional therapies.

  5. Painful stump neuroma or recurrent neuroma: After surgery, the neuroma may reappear or become irritated, causing persistent pain.

  6. Deep vein thrombosis or blood clots: Blood clots in the leg veins are a potential risk after surgery, but they can be avoided with proper evaluation and treatment.

  7. Hematoma: Painful collection of blood around the incision site is another risk, but it is easy to treat.

  8. Nerve damage: During surgery, the nerves in the operated area may be damaged, leading to temporary or permanent numbness.

  9. Delayed healing: Some patients may experience delayed healing, which can be due to infection or other causes.

  10. Chronic regional pain syndrome: A rare complication where pain persists after surgery, requiring consultation with a pain specialist.

It is important to discuss any concerns or potential risks with your surgeon before undergoing Morton’s Neuroma surgery.

04 Close up on senior women feet and hand massage on injury spot Mortons Neuroma Surgery Luxe Foot Surgery Center

Who is most affected by Morton's neuroma?

Among the population groups most likely to suffer from Morton’s neuroma, we find the following:

Women

Studies indicate that Morton’s Neuroma is more prevalent in women than in men. Adult females are 4 to 8 times more likely to suffer from this condition than their male counterparts. The primary reason for this is the use of inappropriate footwear. High-heeled shoes and tight-fitting shoes that force the foot into a pointed shape can exert significant pressure on the front arch of the foot. This leads to a change in the alignment of the metatarsal bones, which can increase pressure on the nerves that pass through the bottom of the foot.

Age

Morton’s Neuroma is most common in individuals aged 50 to 70.

Individuals with foot abnormalities People who already have foot deformities, such as bunions, hammer toes, flat feet (when there is no arch on the sole of the foot), or pes cavus (when the plantar arch is highly pronounced), are more susceptible to developing Morton’s Neuroma.

Athletes

Another group at risk for Morton’s Neuroma is high-performance athletes. These individuals are usually runners who engage in strenuous daily training, such as high-impact athletic activities, jogging, running, etc. These activities can cause persistent foot injury, which can eventually lead to Morton’s Neuroma. Additionally, athletes who wear very tight shoes while performing their activity, even if it is not high-impact, may frequently develop this disorder.

Examination of young woman by orthopedist cropped shot of female doctor holding girl foot_Morton's Neuroma Surgery

How is the diagnosis of Morton's neuroma made?

The diagnosis of this condition goes through several stages to identify and measure it. These stages include:

  1. Patient History: The patient will describe their symptoms to the specialist, including the location and frequency of pain, chronic conditions, and family history.

  2. Physical Examination: The examination begins with the patient standing to observe any deviation in the toes and synovitis in the metatarsophalangeal joint. The specialist will also test the mobility and feel the area for pain. The Mulder click test is also performed by pressing on the plantar surface near the heads of the metatarsals, and if a painful click is felt, it may indicate Morton’s neuroma.

  3. X-Rays: To confirm the results of the physical tests and rule out other causes of pain, the specialist may order x-rays to look for degenerative changes, dislocations, or exostoses in the metatarsophalangeal joints. An MRI may also be performed to detect fibrosis.

  4. Podometry: This technique measures foot pressure and helps determine the distribution of pressure on the bottom of the foot. This information, along with previous tests, can help the specialist determine the most appropriate surgical technique for the patient.

When is Morton's neuroma surgery necessary?

Morton’s neuroma surgery is performed after patients have undergone several of the conservative treatments, with no results. When the severity of the disorder is great, Morton’s neuroma surgery will be the most appropriate option to eliminate the condition. In general, patients who undergo Morton’s neuroma surgery no longer find a remedy for their pain, so their quality of life is affected by this condition. Morton’s neuroma surgery is necessary when:

  • Patients have ongoing pain that does not improve over time.
  • The ball of the foot becomes very painful and makes it difficult to walk.
  • Patients have problems performing their daily activities.
  • The use of footwear is difficult.
  • There is swelling and calluses that cause a lot of discomfort.
  • There is a change in the appearance of the foot and toes.
Most used surgical techniques for Morton's neuroma

Most used surgical techniques for Morton's neuroma

Over time, medical expertise has developed various techniques for Morton’s Neuroma surgery, with or without excision. Below are the most commonly used surgical techniques for this condition.

Radiofrequency technique without neuroma removal

Isolated radiofrequency is used for neuromas that are small or have not been present for long. This technique can be performed when there is no mass effect, and nerve compression maneuvers do not cause dislocation. The radiofrequency technique involves applying energy directly to the nerve, aiming to carry out neuro-modulation. Local and regional anesthesia are used to prevent the patient from feeling pain during the procedure. Anesthesia is administered through the same needle used for radiofrequency.

The aim is to reduce the number of pain mediators created and decrease the sensitivity of the interdigital nerve without removal. Since no incision is required, this technique is minimally invasive, and recovery is faster than conventional open surgery. The procedure typically takes only a few minutes to complete.

Ultrasound-guided surgery with neuroma removal

This technique involves applying ultrasound and radiofrequency in the operating room. The nerve is located using ultrasound, and radiofrequency neuro-modulation is performed. The peripheral release of soft tissues allows access to the neuroma for removal. This minimally invasive surgery uses scalpels, dilators, and hooks of only 2 mm. Recovery time is much shorter than conventional open surgery.

Dorsal surgery with neuroma removal

This conventional open surgery is used when the neuroma is significant. The neuroma is kept localized at all times using ultrasound to differentiate it from intermetatarsal bursitis. An incision of 1.5 to 2 cm is made to access the dorsal area, followed by opening the intermetatarsal ligament and extirpation of the neuroma. This technique has replaced classic plantar surgery, but some patients still require an incision on the sole of the foot.

Percutaneous metatarsalgia surgery without neuroma removal

This type of surgery is applied when the cause of neuroma is a long, misaligned metatarsal bone, or poor support formula. The procedure involves shortening the metatarsal bone under fluoroscopy control. The neuroma is not removed or the ligament opened since it is assumed to disappear when the bone is corrected. This is also a minimally invasive surgery.

What will happen the day of neuroma surgery?

Although Morton’s Neuroma surgery typically takes around 30 minutes, patients will need to stay in the clinic for about three hours, including pre- and post-procedure time. However, the patient can return home the same day since it is an outpatient procedure. When leaving the hospital, the patient will need a companion since their foot will be bandaged with a cast or a boot, and they will not be able to support themselves. The companion must also assist the patient at home for at least the first 48 hours.

Local and regional anesthesia is typically used for the surgery. Anesthesia is administered by injections around the ankle and behind the knee to numb the deeper nerves. The patient will be conscious during the procedure but will not be able to see what the surgeon and their team are doing. General anesthesia may be administered for patients who need it. In any case, the patient will not feel any pain during Morton’s Neuroma surgery.

Goals of Morton's neuroma surgery

The primary goal of Morton’s Neuroma surgery is to alleviate the symptoms that cause discomfort for patients. To achieve this goal, the cause of the pain must be modified, which is the compression of the nerve between the heads of the metatarsal bones. The nerve can be released through extraction or neurectomy, or by release without removal of the nerve.

Difference Between Single Neuroma and Multiple Neuromas

Morton’s neuroma was once believed to be an isolated tumor that rarely affected more than one web space. However, multiple neuromas are now commonly observed. A single neuroma is one that appears in isolation and affects only one nerve, while multiple neuroma indicates that two or more neuromas have developed simultaneously. These neuromas can affect the same nerve or adjacent nerves and can occur in one or more web spaces. Surgery for multiple Morton’s neuroma is more complicated than for single neuroma. These neuromas typically occur between the second and third web space. Below is a table comparing single neuroma and multiple neuromas:
Characteristic Single Neuroma Multiple Neuromas
Number of Neuromas 1 2 or more
Nerve Involvement 1 1 or more
Web Space Involvement 1 1 or more
Complexity of Surgery Less complex More complex
Typical Location Any web space Between 2nd and 3rd web space

Neuroma Surgery Success Rate

The success rate of Morton’s Neuroma surgery is high, ranging from 51% to 85%. This percentage is calculated based on long-term follow-up of patient outcomes. The vast majority of patients who have undergone the surgery report being satisfied with the results of Morton’s Neuroma surgery.

It is important to note that individual success rates may vary depending on factors such as the severity of the condition, the patient’s overall health, and the surgical technique used. It is essential to consult with a qualified surgeon to determine the best treatment option and expected outcomes for each patient.

Conservative Treatments for Morton's Neuroma

As with most foot conditions, there is also a wide variety of conservative treatments for Morton’s neuroma. Conservative or non-surgical methods are the first option before Morton’s neuroma surgery. Statistics indicate that 70% of patients find relief from the condition with these methods, which avoids having to undergo surgery.

Only when the symptoms do not subside after several months practicing conservative treatments, is Morton’s neuroma surgery proposed as a necessary option. Non-surgical methods are focused on relieving the symptoms, since the neuroma will not disappear by itself: it only disappears with surgery. But the symptoms can be greatly attenuated. Let’s see which are the most used conservative methods.

Shoe change

As we have seen, one of the main causes of Morton’s neuroma is the use of inappropriate footwear. For this reason, in conservative treatments, changing shoes is essential for patients to experience improvement. Appropriate footwear must meet the following characteristics:

  • Have good support.
  • Wear arch support.
  • Have a wide toe that does not squeeze your toes.
  • Have a flat sole without a heel.
  • Be well padded inside.
  • Have good cushioning.

Use of protective pads

Using accessories that can be placed inside the shoes to provide greater comfort to the foot, helps to reduce the symptoms of Morton’s neuroma. Protective ball-of-foot pads help reduce physical irritation felt from rubbing against the sole of the shoe. You can also find pads with cutouts that dissipate pressure at a certain point on the foot, usually where the neuroma bothers the most.

Use of braces or orthoses

Orthoses are orthopedic devices made especially for the individual needs of each patient. They are prescribed by the orthopedic surgeon and are made from an exact cast or cast of the patient’s feet. The benefit of these braces is that they provide superior support compared to generic insoles sold in stores like pharmacies.

Ice massage

Putting ice packs on the affected area at least 3 times a day for about 20 minutes helps relieve inflammation in the area affected by Morton’s neuroma. This will also decrease the pain.

Consumption of medicines

The consumption of anti-inflammatory drugs improves the symptoms of those who suffer from Morton’s neuroma. These types of medications help reduce pain and inflammation of the foot. However, this type of therapy should not be sustained in the long term, because it could cause adverse reactions.

Rest

Some patients will have to modify the activities, in order to seek more rest time for the foot. Especially those who have a very busy job, or who practice sports, should reduce the activity, to reduce the effect of the pressure of body weight on the neuroma, and thus avoid painful symptoms. Resting the foot at various times of the day greatly relieves the symptoms. You can also put your foot up to relieve inflammation and take pressure off the foot.

Avoid obesity and overweight

Obesity and overweight are factors that aggravate the situation of those who suffer from Morton’s neuroma. That is why one of the conservative treatments is to maintain the appropriate normal weight according to the age, sex and size of the patient. When there is more weight than recommended, more pressure falls on the foot, and on the affected area, which causes the symptoms of Morton’s neuroma to worsen.

Cortisone injections

Cortisone injections, applied directly to the affected area of the nerve, are another of the most used conservative methods. Cortisone is a powerful anti-inflammatory medication that helps reduce nerve pain. The frequency with which cortisone is applied is one injection every 2 months approximately. Usually 3 injections are given, but sometimes more may be given until the pain subsides.

Sclerotherapy

Another of the conservative methods is sclerotherapy, which consists of injecting sclerosing alcohol around the nerve. This substance causes the nerve’s ability to transmit pain to decrease, which is also known as “damping the nerve.” The patient can feel permanent relief after several sessions of sclerosing alcohol injection. The frequency of treatment is 1 injection per week, for several weeks in a row, until the pain disappears.

Physiotherapy and stretching exercises

The doctor may indicate a consultation with a physical therapist, who will instruct the patient on some suitable stretching exercises to perform at home on a daily basis. This improves the symptoms of Morton’s neuroma. In addition, physiotherapy practices such as ultrasounds may also be indicated to reduce the pain caused by Morton’s neuroma.

MORTON’S NEUROMA SURGERY

Frequently asked questions from our patients

Our patients often have some frequently asked questions about Morton’s neuroma surgery. Next, we will answer these questions. If you still cannot find the answers to your questions about Morton’s neuroma surgery, we invite you to contact our team at Luxe Foot Surgery. You can make a phone call, or communicate through our social networks. If you need a personalized consultation so that we can evaluate the condition of your case, schedule a free appointment with the specialist.

People who feel the symptoms of Morton’s neuroma should go to the family doctor or directly to the specialist surgeon, for an evaluation and diagnosis of their case. Many of our patients want to know what questions they should answer at that first visit, or what is the best way to explain what they are feeling to the doctor. In this section we show you the questions that the doctor can ask you and that you should answer for a correct evaluation of the case, without leaving details to describe. Those questions that should not be missing in your first consultation are the following:

  • How long ago did the symptoms start?
  • Did the symptoms come on gradually or suddenly?
  • What is the type of shoe you wear most often and what is that frequency?
  • Do you practice any sport in particular? How often do you practice it?
  • Do you take any medication or supplement frequently?
  • Do you feel more pain when you wear any type of footwear?
  • Do you do anything to ease the pain?
  • Is the pain concentrated in the foot or do you feel it in some other area of the body?

Local and regional anesthesia is most often used to perform Morton’s neuroma surgery. This type of anesthesia causes local and regional blocks that will be monitored by the anesthesiologist. Although patients remain conscious during the operation they will not be able to see it.

General anesthesia can also be used, although this is the least common. The other option is spinal anesthesia, which is injected directly into the spinal canal of the lumbar spine, and allows the patient to remain conscious during the procedure, but it is also not widely used. Our anesthesiologists have extensive experience in all methods and will be able to explain the details that will allow you to make the best choice, in addition to first evaluating each patient.

On the AOFAS scale, Morton’s neuroma surgery has an average of 72 points, which is why it is considered to have good clinical results, as well as high overall patient satisfaction in the long term.

Studies reveal that when there is a single neuroma, surgery has a higher success rate. When there is more than one neuroma, the success rate decreases. Of course, this does not mean that multiple neuroma surgeries go wrong, because in fact most are successful. But there is more risk in terms of the success of the procedure when there are multiple neuromas involved.

Yes, in the type of Morton’s neuroma surgery where a neurectomy is performed, the affected nerve is completely removed. The entire area where the neuroma has been generated is removed. The excision is done in a deep way, so that there are no remains of the nerve that in the future produce a new neuroma with the typical pains and discomforts.

Morton’s neuroma is considered in some medical literature as a benign tumor, although for some researchers it is not really a tumor. This tumor appears in one of the nerves that run along the sides of the foot. The tumor or neuroma consists of the thickening of the tissue that surrounds the interdigital nerve. It usually appears between the third and fourth metatarsal bones.

Yes, sometimes after patients recover from Morton’s neuroma surgery, the condition can come back. This is known as neuroma recurrence, and is one of the risks of Morton’s neuroma surgery. Between 10% and 30% of patients may have recurrent neuroma. The surgical procedure can be performed again, but with a lower success rate, ranging from 60% to 70%. But before proceeding to surgery, conservative methods can be tried.

No, women are the population group most affected by Morton’s neuroma. It is estimated that a woman is between 4 and 8 times more likely to suffer from neuroma than a man. Most researchers agree that this is because women wear inappropriate footwear more often than men. Shoes with high heels and tight toes are one of the main causes of Morton’s neuroma in women.

For most patients with Morton’s neuroma, when conservative treatments are started, symptoms improve. In some cases the pain is greatly reduced, as well as the burning sensation, numbness and discomfort when walking. We can say that non-surgical treatments are successful, although not for 100% of patients. Some will only find improvement by receiving Morton’s neuroma surgery.

It is normal for a surgical procedure to cause pain, especially during the first few days of recovery. However, there are many ways to prevent patients from feeling a lot of pain after surgery, usually with pain medication plans. From the moment you enter the clinic, on the day of the operation, the anesthetist will be in charge of pain management, performing a nerve block, which relieves foot pain for up to 30 hours. In this way, the strongest pain will be avoided, which is what you feel the first day.

If the vehicle is automatic and the surgery was performed on the left foot, most patients will be able to drive again after the second week of recovery. But if the operation was performed on the right foot, the patient will have to wait until the fourth week of recovery before starting to drive again. In any case, you should always discuss this decision with your surgeon, as not all patients evolve in the same way. Another important detail is to consult with your auto insurance about the rules for cases of people who drive after an operation on the feet.

There are patients who have the feeling that their toe is numb at certain times in isolation. This may be because the nerve has been removed. The sensation is rarely bothersome. Although it worries some patients, it can be normal.

After Morton’s neuroma surgery, patients should experience pain relief. Especially after the first 3 to 4 weeks of recovery have passed, when the wound has healed well. From that moment they will be able to walk again little by little. To start exercising they must wait 3 months. Full recovery should occur at 6 months, which is when the last postoperative review appointment will be made. Until the first year of recovery, it will be normal to have a slightly swollen foot.

After Morton’s neuroma surgery, patients should avoid putting foot down for the first 2 weeks. It is recommended that you keep your foot elevated as long as possible to avoid inflammation and pain. They should remain seated or lying down, and get up only when absolutely necessary. From the second week, when the incision stitches have been removed, they can start walking a little every day until the foot gets stronger, but without forcing it and stopping when the sensation of pain begins.

During rest time, when the patient needs to get up to go to the bathroom or for another reason, special care must be taken not to support the weight of the body on the operated foot. To do this, you can use crutches, a wheelchair, padded surgical boots that prevent the weight of the body from falling on the operated area, or any similar device.

The return to work time will depend on how fast the recovery is and the type of work the patient does. For jobs that are sedentary, in which the patient will be able to remain seated most of the time, they could return to work after the second or third week of recovery. For those jobs that require a lot of physical activity, you can return to work after the second month of recovery. The other detail is transportation to work. It should be in a private car or taxi, to avoid blows in the operated area.

The patient will be able to start walking again from the second week, once the bandage and incision stitches have been removed. You will gradually exercise the foot, increasing the time you walk as the days go by. You should not overexert yourself that causes pain and discomfort. At the beginning of starting to walk again, the foot can become inflamed towards the end of the day. At this time it is best to elevate it.

Yes, after the necessary recovery time, patients can gradually start playing sports. Once your foot adjusts to walking again and feels more comfortable and strong, you can start jogging and running smoothly. Gradually and as long as it is comfortable, the patient can start with contact, torsion and impact sports. You may feel like you don’t have as much agility as you used to, but that will come with practice as your foot regains strength. Normally, to re-establish sports activity well, you must wait until the third month of recovery.

Most medical insurance covers the costs of Morton’s neuroma surgery, since it is not cosmetic surgery. Depending on the type of health insurance, this may cover all of the expenses, or only a part. If insurance does not cover all costs, patients may have to cover a portion of the cost, but it will be the least amount compared to the total cost. At our Luxe Foot Surgery center we have special payment plans.

Morton’s neuroma is considered one of the types of metatarsalgia that exist, or one of the conditions that cause it. This is also why the neuroma is known as Morton’s metatarsalgia. However, there is a difference with what is commonly understood as metatarsalgia, which is the product of a problem of joint and mechanical origin, in the metatarsals and metatarsophalangeal joints. The main difference is that Morton’s neuroma has a nervous origin, and that essentially distinguishes it from other types of metatarsalgia.

  1. Kasparek M, Schneider W. Surgical treatment of Morton’s neuroma: clinical results after open excision. World J Surg. 2013;37(3):740-745. doi:10.1007/s00268-012-1856-7. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3764278/
  2. Bhatia M, Thomson L. Morton’s neuroma – current concepts review. Foot Ankle Surg. 2020;26(1):1-10. doi:10.1016/j.fas.2019.02.001. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7211826/
  3. Koti M, Maffulli N, Al-Shoaibi M, Hughes M, McAllister J. Long-term results of dorsal neuroma/nerve transposition in the surgical management of Morton’s neuroma and correlation with intraoperative anatomical variations. J Orthop Surg Res. 2022;17(1):18. doi:10.1186/s13018-022-02910-2. Available from: https://josr-online.biomedcentral.com/articles/10.1186/s13018-022-02910-2
  4. Jain S, Mannan K. The diagnosis and management of Morton’s neuroma: a literature review. Foot Ankle Spec. 2014;7(1):51-56. doi:10.1177/1938640013493464. Available from: https://journals.sagepub.com/doi/abs/10.1177/1938640013493464
  5. Munir U, Tafti D, Morgan S. Morton Neuroma. In: StatPearls. StatPearls Publishing; 2022. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470249/
  6. Morton TG. A peculiar and painful affection of the fourth metatarso-phalangeal articulation. Am J Med Sci. 1876;71(141):37-45. Available from: https://collections.nlm.nih.gov/ext/dw/101303284/PDF/101303284.pdf
Contact Us

Monday - Friday: 9:00 AM - 6:00 PM