Morton’s Neuroma Surgery

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.