What is a Morton’s Neuroma?
A neuroma is a thickening of nerve tissue and Morton’s Neuroma is a swollen, inflamed common digital nerve located between the bones at the ball of the foot.
The most common location is second (between second and third metatarsal) and third (between third and fourth metatarsal) spaces.
This can cause a sharp, burning, shooting pain in the ball of your foot and sometimes the pain radiates to the toes.
Often referred to as a pinched nerve or nerve tumour, it is five times more common in women due to the wearing of narrow shoes or high heels.
To ease the pain of the thickened nerves those suffering often have to stop walking, take off their shoe and massage the affected area. Which is not ideal to enjoying your best life and participating in sports, dance or working all day whilst standing.
What causes a Morton’s Neuroma?
Although the exact causes are still unclear, anything that causes compression or irritation of the nerve may be believed to cause a neuroma.
Ill-fitting footwear: shoes with a narrow toe box, high heel shoes or shoes with pointed toes.
Being active: playing high impact sports that involve running and placing high pressure on the forefoot such as racquet sports.
Foot deformities: such as Pes planus (flat foot), bunion and hammertoe, tight calf muscle (equinus deformity).
How is it Treated?
Treatments may be operational or non-operational.
Padding: Padding techniques to support the metatarsal arch, thereby reducing the pressure on the nerve and decreasing the compression when walking.
Icing: Placing an icepack on the affected area helps reduce swelling.
Orthotic devices: Custom orthotic devices provide the support needed to reduce pressure and compression on the nerve.
Activity modifications: Activities that put repetitive pressure on the neuroma should be avoided until the condition improves.
Shoe modifications: Wear shoes with a wide toe box and avoid narrow-toed shoes or shoes with high heels. Medications: Oral non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be recommended to reduce pain and inflammation.
Injection therapy: Treatment may include injection of cortisone, local anaesthetic, or other agents such as sclerosing alcohol injection.
Morton’s Neuroma surgery (neurectomy surgery) can be done as a day surgery procedure as it only requires a small incision of 2-3 cm to take the neuroma out. Surgical excision of a Morton’s Neuroma has good clinical results and high overall patient satisfaction in the long term.
When is Surgery needed?
Surgery is considered in patients who have not responded well to non-surgical treatments.
Costs of surgery varies depending on the procedures required for your deformities. During your first consultation, Dr Kim will assess your condition and give you a written quote so you can contact your private health insurance to find out your out-of-pocket costs.
Do I need a referral?
No referral is required to see Dr Kim unless you are claiming DVA or Workers Compensation, which requires specific referral paperwork, and cannot be seen without this.
Are you an Orthopaedic Surgeon?
No, I am not. I am a Podiatric Surgeon who is also recognized as a specialist under AHPRA.
How long will I be off my feet?
Most foot surgery allows patients to be on their feet immediately following the procedure but are expected to wear a protective post-operative shoe over their bandaging to protect the surgical site. In the first 3-7 days, patients are expected to rest as much as possible even when they are able to walk. At your first post-operative review (usually 7 days following), Dr Kim will discuss your progress and anticipated recovery, as well as your progression into normal footwear such as runners and flat casual shoes. For the majority of patients, a return to normal footwear occurs at 3-4 weeks following the procedure although this does vary.
When can I drive?
Generally speaking, no patient should drive a motor vehicle in the first week following surgery. From then on, it is very much dependent on the type of procedure performed. The average time taken off driving is 3-4 weeks.
When can I fly?
Not in the first week. The decision to fly is made on an individual basis for each patient and procedure performed. Flying too soon following surgery can prolong swelling and may theoretically increase the risk of blood clots in the legs (deep vein thrombosis).
When can I work again?
If you work at a desk with minimal time on your feet, it may be as early as one week. More active employment usually is considerably longer.
What are the risks?
Elective foot surgery is very safe. The risks of foot surgery are similar to those of other surgeries such as infection and deep vein thrombosis. There are also risks associated with having certain medicines during and after surgery, such as nausea and vomiting. Any risks associated with surgery are explained during a pre-operative consultation at which time written consent is given. Absolute care is taken to ensure that consent to undergo surgery is only given once all questions have been answered to the patient’s satisfaction and all possible risks have been explained.
Dr Ji Soo, Kim is a highly qualified foot specialist, holding both a Bachelor of Podiatric Medicine and a Doctor of Clinical Podiatry.
He holds dual registration with AHPRA as both a podiatrist and a specialist podiatric surgeon and is a fellow of the Australian Association of Podiatric Surgeons.
Dr Kim and the team at Brisbane and Gold Coast Foot Surgery are dedicated to working with you to accomplish the best possible outcomes for your foot health, mobility, and quality of life.
Specializing in conditions affecting the feet and ankles for patients both young and old. This is achieved with treatments or surgery that will help you regain your lifestyle, movement, and mobility so you don’t miss out on living your life to the fullest.
Why Choose Us?
Dr Kim takes his time to clearly explain non-surgical and surgical treatments of your problems and if surgery is deemed necessary, he will thoroughly explain procedure and risks/ complications.
Dr Kim believes the post-op care is the most important, so his mobile number is given to all patients after surgery to make sure he is only a phone call away if you have any questions about your recovery or when he is needed.
What is Podiatric Surgery?
Podiatric surgery is a specialty of the podiatry profession that specializes in the surgical and non-surgical treatment of foot, ankle, and related extremity structures. Podiatric surgeons are recognized as registered specialists by AHPRA (Australian Health Practitioner Regulation Agency) and perform hospital-based surgery within private hospital and licensed day surgery centers.
Information about Medicare & Private Health Insurances.
Podiatric surgery is currently not covered under Medicare. Most private health insurance funds provide rebates for a range of podiatric surgery services, including hospital costs and surgeon’s costs, but this depends on your level of cover.
If your private health insurance only covers a small part of podiatric surgery, you may change your health insurance to one that does choose to cover some or all of this service, lobby your fund to change its policy and/or provide you with what is called an ‘ex-gratia’ payment.