Should I have Morton’s neuroma surgery?
or why shouldn’t I have Morton’s neuroma surgery?
In some patients Morton’s neuroma surgery is unavoidable because their Morton’s neuroma is resistant to any other means of treatment. However in the vast majority of cases surgery is avoidable. (We only consider surgery for Morton’s neuroma as a last option when all other non-surgical treatments have failed.)
Our Medical Director Discusses Morton’s Neuroma Surgery:
We generally advise against Morton’s neuroma surgery because:
- Effective other treatments. We can effectively treat Morton’s neuroma without surgery, (in many cases more effectively than surgery) and the recovery time from our procedures is only a couple of days.For more information on the non surgical options we offer to treat Morton’s neuroma, click here.
- Complications. Surgery for Morton’s neuroma is often associated with complications, most commonly post surgical pain. In many cases the post surgical foot pain may be as bad or worse as the foot pain before surgery. Some studies have shown that up to 35% of patients who have surgery end up with unacceptable levels of post surgical pain.
Post Morton’s neuroma surgery foot pain is much more difficult to treat than pre surgery Morton’s neuroma foot pain because the exact cause of your pain after Morton’s neuroma surgery can be difficult to determine. It can even be difficult to localize the exact position of your pain after surgery! Post Morton’s neuroma surgery pain can be due to a stump neuroma, nerve degradation, scar tissue or another post surgical complication. For more information on pain after Morton’s neuroma surgery (“post neurectomy pain”), click here.
- Foot instability. Most first time Morton’s neuroma surgery is done through the top of the foot (the “dorsal” approach) which involves cutting through the the transverse metatarsal ligament. Although this results in a shorter recovery time than operating through the bottom of the foot, it results in more post operative foot instability, with forefoot splaying and potential long term gait problems.
- Long recovery. The basic recovery time from Morton’s neuroma surgery is frequently 3 or possibly 4 weeks, even if a top of the foot (“dorsal”) surgical approach is used and it can easily take 3-4 months to for the full effects of surgery. In other words, it can take 3-4 months to become fully mobile.
- Surgery redo’s. If another surgery is required, the success rate of a Morton’s neuroma redo surgery is considerably lower than the success rate of a first time Morton’s neuroma surgery. The redo Morton’s neuroma surgery is most commonly done through an incision in the bottom of the foot (the “plantar aspect” of the foot.) This approach results in an even longer and more painful recovery than a regular Morton’s neuroma surgery. It can take 4-6 months of painful recovery to fully recover from a redo Morton’s neuroma surgery.
- General surgical risks. There are always general surgical risks associated with any surgery and so surgery should always be avoided if possible.
However, in some cases when Morton’s neuroma is resistant to other treatments, surgery is the only option left and is unavoidable.
For more information on the non surgical options we offer to treat Morton’s neuroma, click here.
VIDEO TEXT: We don’t recommend surgery as a treatment for Morton’s neuroma unless as a very last resort. Surgical removal of the Morton’s neuroma requires being off the foot for months and may result in worsened pain from a stump neuroma or scar tissue that’s extremely difficult to treat. With few exceptions, nerves are not intentionally cut as part of surgery, so it’s not that surprising that cutting out a Morton’s neuroma can lead to more problems. My advice about surgery for Morton’s neuroma: don’t go there without coming here. If you suffer from pain in the forefoot that you think might be Morton’s neuroma, call us so we can help you get back on track.
Don’t Suffer Any Longer…
Janet D. Pearl, MD, MSc is the Medical Director of The Center for Morton’s Neuroma and Complete Spine and Pain Care, an interventional and integrated Pain Management program located in Framingham, Massachusetts. Previously, Dr. Pearl was the Co-Director of the Pain Management Center at St. Elizabeth’s Medical Center, where she was also the Director of the Fellowship program. She is the former Director of a satellite pain center of the Brigham and Women’s Hospital, Pain Management Center, located at the HealthSouth Braintree Rehabilitation Hospital. Dr. Pearl held academic appointments at Harvard Medical School and Tufts Medical School. She serves on the Health Care Services Board of the Commonwealth of Massachusetts Department of Industrial Accidents since 2000 as one of its physician representatives and is Chair of the Committee on Pain Management.