Have you ever gotten a pebble stuck between the bottom of your foot and your shoe? Or how about an irritating fold or bunch in your sock that you had to take off your shoe to smooth out? If so, you probably have an idea of what a Morton’s neuroma can feel like.
Of course, if you already have a neuroma, then you live with this irritation every day. And no amount of smoothing out your socks or shaking out your shoes can make it go away.
As with many progressive foot conditions, there are two broad treatment categories we can pursue for a neuroma: conservative and surgical.
If you’re reading this blog post, chances are good that you’re starting to explore whether the latter may be a good option. While it can’t take the place of a professional evaluation, we hope you find the information useful as you weigh your choices.
But before we get into the pros and cons, let’s address an important prerequisite:
You Should ALWAYS Exhaust Non-Surgical Options First
Neuroma surgery does tend to be highly successful on average, and the vast majority of patients experience good results. However, no surgery is completely without risk, and you’ll be making irreversible changes to your body.
By contrast, while non-surgical remedies may not always be able to provide adequate results (especially if your neuroma is severe), there are usually no significant or permanent drawbacks to attempting them first and seeing if they work.
That is why, except in rare circumstances, we always recommend that you fully pursue all potentially applicable conservative remedies first. Quite often, the use of foot pads, orthotics, or even just roomier shoes can greatly reduce your discomfort and return you to full activity.
Surgery would then only be considered in cases where conservative treatments have been thoroughly explored over the course of at least 2-3 months and still failed, or if the neuroma is so severe that conservative treatments are unlikely to work and you need relief sooner.
Neuroma Surgery: A Quick Overview
The most common surgery chosen for Morton’s neuroma is simply to remove the nerve that’s causing trouble. The interdigital nerves serve a purely sensory function, so toe movement should not be affected.
In some cases, instead of removing the nerve we may be able to cut surrounding structures in order to alleviate the pressure on the nerve.
Either way, the surgery is typically performed in our office and takes about 30 minutes.
Pros of Neuroma Surgery
The biggest and most obvious benefit of surgery is that it gets rid of the problem. And if your neuroma is severe, it really may be your only option to return to an active, pain-free lifestyle.
There’s no way to “shrink” a neuroma once it’s already formed. The enlarged nerve tissue will never go back to normal. Non-invasive methods like padding or orthotics may be able to accommodate a neuroma to your satisfaction, but only surgery can remove it.
And again, the good news is that this is a procedure that we have performed hundreds of times, and the overall success rates are very high.
As we said, no surgery is completely without risk. But for those suffering and not able to live life on their own terms, surgery can, and almost always does, greatly improve their quality of life.
Cons of Neuroma Surgery
While most people experience few short-term and no long-term ill effects from surgery, there are always potential drawbacks to consider:
- Wounds/infection risk. Although infections are uncommon, they may occur in around 2 percent of cases. If you do develop one, early detection and treatment with antibiotics can greatly reduce the risk of severe complications.
- Post-operative pain and swelling. Normally this is relatively minor and gradually recedes over the course of about 12 weeks. Sometimes, however, the remaining “stump” of nerve tissue may attempt to regrow and form what’s known as a “bulb neuroma” that can be painful on its own if it’s in a high-pressure spot. If pain is more severe or persists after your original surgery, a second procedure may be required.
- Loss of sensation. If we’re removing part of the interdigital nerve, some minor sensation loss in the “web space” of the adjacent toes is expected. Usually, this region is very small and the numbness is inconsequential for day-to-day activities. That said, in rare cases numbness can extend to the entire toe.
- Recovery time. Although the timetable varies depending on the procedure and the individual, you can typically expect anywhere from a few days to a few weeks of time off from work (depending on how much walking or standing your duties require you to do). Returning to sports and other physically vigorous activities takes longer—usually around 3 months.
Of course, if you’re already experiencing pain that keeps you from living your preferred lifestyle, a few months of downtime seems like a very small price to pay when compared to permanent downtime!
Helping You Make the Right Call
Our goal at Family Foot & Ankle is not to blindly push one particular treatment over the other, but to carefully evaluate your situation, help you understand the pros and cons of any potential procedures, make our recommendations, and help you make an informed choice about your health care.
If we think surgery may be the right decision for your situation, we’ll certainly let you know. However, we also understand that most people would prefer to avoid surgery if possible, and we will gladly do whatever we can to help you address your problem conservatively.
And if you want the best possible probability of being able to treat your neuroma successfully without surgery, you should seek our help as early as possible—before the pain becomes severe enough to dramatically impair your quality of life!
Schedule an appointment at one of our Greater Cincinnati offices today by dialing (513) 728-4800, or request an appointment online. We look forward to seeing you!