Neuroma

What is Neuroma?

A neuroma is a painful condition characterized by a trapped and swollen nerve typically found in the forefoot. It often causes numbness or sharpness in the toes, with patients reporting sensations such as burning or tingling. Conservative and surgical treatment options are available, with around 80% of patients managed successfully without surgery.

Morton’s Neuroma specifically refers to a swelling and thickening of the nerve under the foot, just before the toe web-space. When walking, the compressed nerve can cause pain, often felt as a burning sensation that may radiate to the toes.

women messaging her feet sitting on sofa .
What Causes a Neuroma?

Morton’s neuroma is a relatively common condition, particularly among females, and it occurs when one of the nerves between the toe bones becomes irritated and thickened. Several factors can contribute to the development of a neuroma:

  1. Footwear: Wearing tight, pointy, or high-heeled shoes can increase pressure on the forefoot, leading to irritation and thickening of the nerve.
  2. Physical activity: Engaging in activities that involve repetitive impact on the feet, such as running or sports like racquet sports, can exacerbate neuroma symptoms by placing additional pressure on the affected nerve.
  3. Foot issues and deformities: Conditions such as flat feet, bunions, or hammer toes can alter the biomechanics of the foot, leading to increased stress and irritation on the nerves, thereby increasing the risk of developing a neuroma.

It’s important to address these contributing factors to help prevent or manage Morton’s neuroma effectively. This may involve wearing properly fitting footwear, modifying activity levels or techniques, and addressing underlying foot issues through orthotic devices or other interventions.

What are the Treatment Options for a Neuroma?

Treatment options for a neuroma typically involve both non-surgical and surgical approaches:

  1. Non-Surgical Treatment:
    • Painkillers: Over-the-counter pain medications such as ibuprofen or acetaminophen may help alleviate pain and discomfort associated with a neuroma.
    • Custom Orthoses: Custom-made orthotic devices or shoe inserts can help redistribute pressure on the foot and provide support, reducing irritation on the affected nerve.
    • Pain-relieving Injections: Corticosteroid injections may be administered directly into the affected area to reduce inflammation and relieve pain temporarily.
  2. Surgical Treatment:
    • Surgery for Severe Cases: If conservative treatments fail to provide relief and the pain from Morton’s Neuroma is severe, surgical intervention may be recommended. The specific surgical procedure may involve removing the affected nerve or releasing pressure on the nerve to alleviate symptoms.

The choice between non-surgical and surgical treatment depends on the severity of symptoms, individual circumstances, and response to conservative measures. It’s essential to discuss the available options with a healthcare with your podiatric surgeon to determine the most appropriate course of action for managing a neuroma effectively.

What Happens During Surgery?

Surgery to remove Morton’s Neuroma typically involves making an incision on the top or bottom of the foot to remove the affected nerve.

Risks and potential side effects include pain, swelling, infection, deep vein thrombosis, and Complex Regional Pain Syndrome. Specific complications may include stump neuroma, scarring, continued discomfort, permanent numbness, and development of scar tissue. It’s crucial to discuss these risks with your surgeon provider before undergoing surgery.

What Happens After Surgery?

After surgery to remove Morton’s Neuroma, you will be taken back to the ward where you’ll be given a drink and something to eat. You’ll also receive instructions on taking painkillers and be provided with a post-operative boot to wear. Once you’re ready, you’ll be discharged from the day surgery unit.

It’s important to note that you should not drive after foot surgery, so you should arrange for a responsible adult to accompany you home.

You will also be informed of your follow-up appointment date, either on the day of surgery or through a letter sent in the post. This follow-up appointment is essential for monitoring your recovery progress and addressing any concerns or issues that may arise.