Morton’s Neuroma
What is it?
Morton’s neuroma is a painful condition that affects the ball of the foot usually between the third and fourth toe. It involves a thickening of the tissue around on the nerves that lead to your toes and can cause a sharp, burning pain in the ball of the foot as well as stinging, burning or numbness in your toes.
In order to properly diagnose Morton’s neuroma your doctor may order x-rays to rule out other causes of pain. Ultrasound and MRI may also be used to better look at the soft tissues.
What are the treatment options?
Treatment will depend on the severity of symptoms. Your doctor may recommend you wear arch supports and foot pads to reduce pressure on the nerve; these may be over the counter or ordered custom so that they fit the exact contours of your foot.
Other options include steroid injections to the affected area, decompression surgery which relieves pressure on the nerve by cutting nearby structures and removal of the nerve if all other treatment options fail to provide relief.
Procedure Goals
Relieve pain to affected area by removing the neuroma.
Risks of the Procedure
Patients undergoing any surgery are subject to risks of infection, wound healing problems, nerve injury, deep vein thrombosis and pulmonary embolism.
What to Expect
Before Procedure
The day of the procedure, you will need to arrange for a ride to and from the procedure and arrange for help at home.
Wear shorts or loose pants and a t-shirt for surgery.
Do not eat or drink anything after midnight for arrivals before noon. Otherwise, do not eat or drink anything seven hours prior to your arrival at the surgery center.
If crutches or a walker are needed, please rent or borrow them prior to your surgery.
You will be contacted by Lawrence Surgery Center to set up your patient account. They will inform you of your pre-operative instructions as well as tell you when to arrive for surgery.
After Procedure
Expect to have some numbness to the medial or inside border of involved toes.
Discharge Instructions
Diet
- You may resume your regular diet. However, start slow with clear liquids and gradually work your way back to your normal diet. This will help prevent nausea and vomiting.
Ankle Care & Bathing
- If applicable, use crutches as directed.
- Keep your ankle elevated above heart level as much as possible for the first five hours, then as needed when symptomatic for up to two weeks. This will prevent painful swelling and promote healing.
Cold Therapy
- To help reduce pain and swelling, apply an ice pack to the surgical area for 20 to 25 minutes every one to two hours for the first 48-96 hours and then as needed to help control pain and swelling.
- To avoid frostbite, place a towel or t-shirt between the ice pack and your skin.
- It is not necessary to use ice while sleeping.
Pain Medication
- Your physician will give you a written prescription for pain medicine as you leave the surgery center. Take your pain medication as prescribed. You may want to take it regularly for the first 48 hours after surgery. Do not take any additional Tylenol.
- While you are asleep in the operating room, a long acting numbing medication may be injected into the surgical area to help relieve your immediate postoperative discomfort for up to 24 hours. When you first notice tingling or throbbing, begin taking your pain medicine so it will become effective before the local anesthesia wears off.
- No driving while taking any narcotic pain medication!
- The pain medication may cause some nausea so take it with food.
- The pain medication and general anesthesia may also cause constipation, so you may need to take a stool softener, fiber bar, Metamucil or prune juice to prevent constipation.
Follow-up Care
- Watch for temperature > 101.5F, persistent numbness and tingling in the foot, persistent bleeding or drainage from the wound, foul odor, progressively worsening pain that is unresponsive to pain medication, blue toes, chest pain or difficulty breathing. If you have any of these symptoms, call the office if during normal business hours or go to the nearest emergency room.
- If you do not have a postoperative appointment set-up already, please call the office to schedule an appointment for 7-10 days after surgery at (785)843-9125.
Rehabilitation Plan - Exercises
Rehab may be prescribed in order to improve toe and foot mobility as well as decrease pain.