What Causes Morton's Neuromas?
Morton's Neuroma is another type of peripheral nerve problem in the foot caused by the repetitive compression of the common plantar digital nerve. This nerve lies between the heads of the metatarsal bones. Consequently, the neuroma that develops is not a true neuroma, but rather chronic nerve compression. Tight shoes and high heels can intensify this type of pain. If the Morton's Neuroma has already been operated on by another physician and he/she cut the nerve, then the Morton's Neuroma is a true neuroma and the nerve needs to be resected. For this type of Morton's Neuroma see the next section on nerve injuries.
Are There Non-Surgical Treatment Options for Morton's Neuromas?
Morton's Neuroma symptoms can often be alleviated by wearing flat, wide-toe shoes or Orthotic devices made by a podiatrist. Other treatments include the use of arch supports or custom-fitted shoes to redistribute weight away from the area.
Who Is A Candidate For Morton's Neuroma Surgery?
To determine whether of not you are a good candidate for surgery Dr. Maloney and his staff will use the PSSD (pressure specified sensory device) to measure the function of your nerves. This is a non-painful and non-invasive test that quantifies the sensory loss of the nerve. This test will also verify the patient does not have problems with other nerves and the Morton's Neuroma is an isolated problem. Patients who are under the age of 75 that are in good health with abnormal PSSD test in the distribution of their other nerves are typically good surgical candidates. The PSSD can also help identify those individuals who have been misdiagnosed as having a Morton's Neuroma and actually have a mild early peripheral Neuropathy.
What Can I Expect During and After Morton's Neuroma Surgery?
Morton's Neuroma surgery is an outpatient procedure taking about and hour. A general anesthetic is used in most cases though in rare instances a spinal block may be used. Once Dr. Maloney finds the nerve, he releases the area of compression and cuts the tight band that is compressing the nerve. Dr. Maloney DOES NOT CUT THE NERVE. After Dr. Maloney is done with the operation a dressing is placed and the patient is transferred to the recovery room. There are some patients that notice an immediate difference in there pain as they wake up in the recovery room, others it can take up to several months depending on the amount of compression and the amount of time since the compression presented. The patient is sent home and asked to use a walker or crutches for the first week to minimize the amount of pressure placed on the operative foot. After the first week the dressing is removed and the patient may put on a shoe and sock. The final sutures are removed three weeks after surgery and at this time the patient is released to normal activity.
Are There Any Risks Involved With Morton's Neuroma Surgery?
The biggest risk with this operation is that patients may still be left with areas of pain or there is no change in the amount of pain. The most common risks associated with any type of surgical procedure include bleeding, infection and scaring. Other risks include an increase in pain (which is usually the progression of the neuropathy not an operative complication) or DVT which are very uncommon.
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Call 520.298.2330 if you have any questions regarding the information above, or fill out the form in the sidebar to ask Dr. Maloney any questions you have.