Treatment and Rehabilitation following surgical removal

 

Morton’s neuroma is a condition that affects the nerves in the foot, typically between the third and fourth toes. It occurs when the tissue around a nerve in the ball of the foot thickens, causing pain, numbness, or a burning sensation in the affected toes. The exact cause of Morton’s neuroma is not always clear, but it’s often associated with wearing tight or high-heeled shoes that compress the toes and put pressure on the nerves.

Treatment for Morton’s neuroma can vary depending on the severity of symptoms. Here are some common options:

  1. Footwear modification: Wearing shoes with a wider toe box or lower heels can help relieve pressure on the affected area and reduce symptoms.
  2. Orthotic devices: Custom orthotic inserts can help redistribute pressure on the foot and provide support, which may alleviate symptoms.
  3. Medications: Over-the-counter pain relievers like ibuprofen or naproxen can help reduce pain and inflammation associated with Morton’s neuroma.
  4. Corticosteroid injections: Injections of corticosteroid medication directly into the affected area can help reduce inflammation and alleviate symptoms. However, the relief is often temporary and may need to be repeated periodically.
  5. Physical therapy: Stretching and strengthening exercises can help improve the flexibility and strength of the foot muscles, which may reduce pressure on the affected nerve.
  6. Surgery: If conservative treatments fail to provide relief, surgery may be considered. The goal of surgery is to remove the affected nerve or release pressure on it. There are different surgical techniques used for Morton’s neuroma, including nerve decompression, neurectomy (removal of the nerve), or ligament release. Success rates generally range from 70% to 90%, with most patients experiencing significant improvement in symptoms following surgery.

 

Following neurectomy for Morton’s neuroma, rehabilitation is essential to optimize healing, restore function, and prevent complications. Here’s a general outline of the rehabilitation process:

  1. Initial post-operative period (1-2 weeks):
    • Immediately after surgery, the foot may be wrapped in a bulky bandage or splint to minimize swelling and provide support.
    • It’s important to keep the foot elevated above the level of the heart to reduce swelling and promote circulation.
    • Pain management is crucial during this period. Dr Kim may prescribe pain medications or recommend over-the-counter pain relievers as needed.
    • Avoid putting weight on the operated foot. Crutches or a walker may be necessary to assist with mobility.
  2. Transition to weight-bearing (2-6 weeks):
    • As swelling decreases and healing progresses, Dr Kim will provide guidance on when you can begin bearing weight on the operated foot.
    • Physical therapy may be initiated to help regain strength, flexibility, and range of motion in the foot and ankle.
    • Gentle exercises such as toe curls, ankle pumps, and range of motion exercises may be prescribed to prevent stiffness and improve circulation.
  3. Progressive strengthening and mobility (6 weeks to 3 months):
    • Physical therapy will focus on gradually increasing weight-bearing activities and strengthening exercises for the foot and ankle.
    • Balance and proprioception exercises may be incorporated to improve stability and reduce the risk of falls.
    • Walking, stair climbing, and other functional activities will be gradually introduced based on your progress and tolerance.
  4. Return to normal activities (3 months and beyond):
    • Depending on the extent of surgery and individual healing, most patients can expect to return to normal activities within 3 to 6 months.
    • It’s important to follow Dr Kim’s recommendations regarding footwear, activity modification, and gradual return to sports or high-impact activities.
    • Ongoing monitoring is important to ensure proper healing and address any concerns or complications that may arise.

 

Please see our facebook page for more pre and postop photos.

 

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