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Morton’s Neuroma

Morton’s Neuroma

It can feel like a small knob and when pressed produces a shooting pain, numbness and tingling between the toes and in the ball of the foot.

Morton’s Neuroma

Stay active all day. Enjoy sports and dancing again.

A painful condition affecting the foot, Morton’s neuroma affects the ball of the foot. Commonly between the metatarsals, you may experience a sharp burning pain in the ball of your foot. It may feel like a small knob and, when pressed, produces a shooting pain, numbness and tingling between the toes and the ball of the foot.

Often referred to as a pinched nerve or nerve tumour, it is 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 for enjoying your best life and participating in sports, dancing or working all day whilst standing.

Morton’s neuromas are usually diagnosed with clinical assessment and scans such as ultrasound or MRI. Dr Kim, a specialist podiatric surgeon can assess your foot and order scans as necessary during a consultation.

Causes

The exact causes of Morton’s neuroma are still unknown.

Apart from narrow tight shoes another possible cause is from a foot injury or abnormality leading to instability which may put pressure on a nerve in your foot.

Morton’s neuroma can also develop due to physical activity, running or racquet sports. Similar to the repetitive traumatic stress that professional ballet dancers undergo.

Morton’s neuroma is often associated with:

  • flat feet
  • bunions
  • hammertoe
  • tight calf muscle

Treatment

The initial treatment of Morton’s neuroma is usually conservative.

Non-operational Treatment

Padding: Padding techniques (metatarsal dome) to support the metatarsal arch which reduces the pressure on the nerve and decreases compression when walking. It is recommended that it is placed by your treating professionals such as podiatrists.

Icing: Placing an ice pack 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 forefoot especially neuroma areas 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 nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be recommended to reduce pain and inflammation.

Injection Therapy: Injections of cortisone with local anesthetics or other agents such as sclerosing alcohol injection may reduce symptoms.

Radiofrequency Ablation: The pathologic nerve is heated with heating needle so it can no longer transmit pain. It is usually done by a specialist interventional radiologist.

Surgery

Surgery is advised if non-surgical treatment fails.

Morton’s Neuroma Surgery

Morton’s Neuroma surgery (neurectomy surgery) can be done as a day surgery procedure as it only requires a small incision of 2 – 3cm on the top of the foot. The surgery usually takes between 15 and 20 minutes under general anesthesia or intravenous sedation by a specialist anesthetist.

Surgical excision of a Morton’s neuroma has good clinical results and high overall patient’s satisfaction in the long term.

Recovery

First 2-4 days

  • This is the worst time for pain
  • You must rest completely for the first 2-4 days with your foot elevated just above hip level as much as possible.
  • You may try circulation going by gently drawing circles in the air or wiggling your toes.
  • You should restrict your walking to minimal activities such as going to the bathroom only.
  • You may be able to bear a little weight on the heel in a postoperative shoe

One week after surgery

  • You will need to attend for your foot to be checked and re-dressed.
  • You may start to do a little more within pain limits, but still restricted.
  • Pain may mean you are doing too much

Two weeks after surgery

  • Your second appointment with Dr Kim for removal of stitches. In most cases, absorbable stitches are used so only trimming the ends.
  • Once stitches are removed, you may have your foot wet in the shower.
  • Your foot will still be quite swollen but you should be able to get a roomy shoe on or stay in postopertive shoe.
  • You will be advised on an incremental return to activity and may also be advised on scar care

Between 2-6 weeks after surgery

  • you can return to shoes if no pain with normal shoes.
  • The foot will still become swollen especially at the end of the day or if you do too much weightbearing.
  • You require a review appointment at 4 weeks.
  • You may be able to return to work but may need longer if you have an active job. If in doubt, please discuss this with Dr Kim.
  • You may return to driving if you can perform an emergency stop. You must check with your insurance company before driving.
  • Whilst normal activity will be resumed, sport should be avoided.

Between 8-12 weeks after surgery

  • The foot should continue to improve and begin to feel more normal again.
  • Sports activities can be considered depending on your recovery

Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.

Podiatric Surgeon Dr Kim is the leading surgeon for Foot Surgery in Brisbane and Gold Coast, contact him today to see if you are a good candidate for Neurectomy surgery

No referral needed

Contact Us

A GP referral is welcome however it is not essential for your appointment

About

Dr Ji Soo Kim (Specialist Podiatric Surgeon) BPodM, DClinPod, FFPM RCPS(Glasg)

Book Appointment

Dr Kim has two offices, one located in Kelvin Grove, Brisbane. The other is in Southport, Gold Coast.

Please call 1300 522 096

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