Morton’s Neuroma Surgery

Morton’s neuroma is a common condition that affects the forefoot. Patients often complain of pain in the ball of the foot where they feel like they’re walking on a small pebble or a lump in the ball of the foot due to fibrous thickening of the interdigital nerve. The nerve becomes scarred and enlarged due to fibroblastic activity, which are essentially inflammatory cells that cause significant inflammation of the sensory nerves, resulting in a range of symptoms in the forefoot.

Symptoms and causes of Morton’s Neuroma

Symptoms of Morton’s Neuroma include pins and needles to the digits, sometimes swelling and pain in the ball of the foot, limping and clawing of the toes, numbness in the affected toes. It most commonly affects the third and fourth toes, but it can also be the second and third toes.

When is surgery recommended?

Surgery is recommended when conservative treatment fails. Conservative treatments include use of a metatarsal dome pad and insoles, stretching your calf muscles, and possible steroid injections to reduce inflammation. Should they fail to resolve the symptoms, then you should consider surgical intervention where a neuroma excision is performed.

When should I see a doctor?

You should see a doctor early if wider shoes have not helped. A podiatrist or orthopaedic surgeon can help advise on appropriate insoles, can perform an injection and sometimes advise on surgery if needed.

Types of Morton’s neuroma surgery

The types of morton’s neuroma surgery either include release of the nerve or decompression of the area or excision of the nerve. Other newer treatments such as cryogenic neuroablation or radiofrequency ablation have some evidence but are limited. Excision appears to have the highest success rate.

Interdigital Neuroma Surgery

Excision of a neuroma is where part of the damaged nerve that is causing pain and irritation is removed. The procedure may be carried out under local anaesthesia, sedation or general anaesthesia as a day case; you will only need to be admitted into hospital for half a day. Your surgeon will make a small incision over the top of the foot above the neuroma. Nerves on either side of the neuroma are carefully cut and the neuroma is removed.

What are the alternatives to surgery?

Surgery for Morton’s Neuroma is often a last resort treatment and will be attempted if more conservative measures have failed to resolve the issue. See non-surgical treatments for Morton’s Neuroma

Morton’s neuroma surgery recovery

Typically the procedure can be performed under local anaesthetic with or without sedation. You can expect two weeks of rest where you’re mobilising in the post-op shoe for 10 to 15 minutes an hour. After two weeks you can transition to trainers and push yourself to 20 minutes. Sports would be gently allowed at four weeks and running is allowed after six to eight weeks.

Risks and complications after surgery

The main risk is stump neuroma, which is approximately 2% where the nerve grows back and causes pain and requires further intervention such as injection or possible surgery. Other risks like infection, clots, delayed healing, continued pain are risks associated with all types of surgery.

Cost of Morton’s neuroma surgery

Typical costs are approximately £3,500 for a day case procedure. We will calculate the cost based on individual needs such as type of anaesthesia and number of neuromas removed.

Frequently asked questions

Is surgery warranted for Morton’s neuroma?

If conservative treatment fails, then surgery is the only last resort and long-term treatment for Morton’s neuroma and it has a high degree of success rate.

How long is recovery for Morton’s neuroma surgery?

Typically two weeks of rest and another four weeks of careful mobilisation is required.

What is neuroma excision?

It is removing the sensory nerve that is damaged. The area where the nerve is thickened is removed by the surgeon.

What is the cost of Morton’s neuroma surgery?

Typically costs are around £3,500 for a day case procedure.

How common are Morton’s neuromas?

They are often seen more in women than men, this is due to the nature of the type of footwear. They are one of the top five foot conditions in terms of frequency.

What happens if a Morton’s neuroma is left untreated?

It will cause continued pain and you may have to adapt the way you walk and therefore cause other musculoskeletal problems due to the pain.

Can a Morton’s neuroma come back after treatment?

Yes, but in a small degree of cases. Most studies report less than 5% and in my experience it’s approximately 2% recurrence rate.