Most patients' symptoms subside when they change footwear to a
wide soft shoe with a metatarsal support inside to relieve the pressure
on the involved area. If this treatment fails, a cortisone injection
into the nerve is occasionally helpful.
Operative Treatment
When conservative measures are unsuccessful, surgery can be a good choice in the treatment of Morton's neuroma.
The operation for Morton's neuroma does not require an overnight hospital
stay. The anesthetic used is an ankle block, which completely
numbs the foot during the surgery.
The physician removes the neuroma from an incision made on the top of the foot between the involved metatarsal heads.
The nerve to the interspace is exposed and cut next to the metatarsal heads.
What types of complications may occur?
The main complication resulting from a neuroma excision
(removal) is a recurrence of the neuroma. The nerve itself
doesn't return, but whenever a portion of a nerve is removed, the
stump will form a little bulb known as a traumatic or stump
neuroma. If this traumatic neuroma is located beneath a metatarsal
head or becomes quite large, it may become painful several years after
the initial surgery. Most studies have shown that although 80% of
patients do well after the removal of a neuroma, 20% will have some
degree of nerve pain following the surgery.
Occasionally after surgery, the patient will have an area of numbness on the bottom of the foot which is described
as feeling like a wrinkle in the sock. This discomfort usually disappears in time.
