When Should I Have Surgery For Morton’s Neuroma?
Most patients seek immediate medical help. After a course of conservative treatment and perhaps a corticosteroid steroid injection, most patients are offered the option of surgery for Morton’s neuroma. Do you really need surgery? Is so when?
Do I Need Surgical Intervention For Morton Neuroma management?
Most importantly, your diagnosis of Morton’s neuroma must be accurate and correct before you consider any procedures or surgery. In other words you should know that you have a Morton’s neuroma and that your Morton’s neuroma is the cause of your foot pain. For information on the diagnosis of Morton’s neuroma see here.
Ideal Treatment Options For Morton’s Neuroma:
In clinical practice, surgical removal of your Morton’s neuroma is the least preferred treatment for Morton’s neuroma and should be only performed after all other non-surgical procedures have been tried.
We recommend the following non-surgical procedures before surgery:
- Ultrasound guided Cryosurgery
- Ultrasound guided Radiofrequency ablation
- Ultrasound guided neurolytic injections
- Ultrasound guided Platelet Rich Plasma injections
It is important to consider that some individuals (those with long complex histories or who have had numerous procedures,) may sometimes require more than one sessions of radiofrequency or cryosurgery (depending upon the site and severity of your Morton’s neuroma) to induce complete resolution of symptoms. However when done by experienced providers, these ultrasound guided procedures are safe and very effective.
Surgical Intervention For The Treatment of Morton’s neuroma:
Most healthcare providers avoid Morton’s neuroma surgery because:
- The success rate of surgery is around 70% at best(1);
- The rate of complications is fairly high. For example, more than 72% patients develop permanent numbness (or loss of sensations) in the area of involvement. Other common complications include; painful scar formation, neuroma stump formation, infection and other ailments(2);
- A fair percentage of surgical patients experience recurrence of neuroma after surgery (at a different site or in the vicinity); and,
- The return to normal day-to-day activities can take months after surgery. On the other hand, the return to activity is very short with most ultrasound-guided procedures.
In summary, based on the latest data and clinical estimates, lifestyle modification and the ultrasound guided minimally invasive procedures listed above are highly effective in resolving most cases of Morton neuroma. Surgery should be left as a last resort.
- Chuter, G. S., Chua, Y. P., Connell, D. A., & Blackney, M. C. (2013). Ultrasound-guided radiofrequency ablation in the management of interdigital (Morton’s) neuroma. Skeletal radiology, 42(1), 107-111.
- Kasparek, M., & Schneider, W. (2013). Surgical treatment of Morton’s neuroma: clinical results after open excision. International orthopaedics, 37(9), 1857-1861.