Woman took off heeled shoe due to pain

Pros and Cons of a Neuroma Excision

Having a small stone in your shoe as you stand or walk can cause discomfort and pain in the ball of your foot. 

Now imagine if it wasn’t a stone you can remove to bring relief, but instead a situation where those symptoms don’t disappear and can worsen — including with numbness and tingling. 

You might be suffering from a condition called Morton’s neuroma, a thickening of the tissue around a nerve that leads to the toes. Though “neuroma” usually refers to a nerve tumor, the condition is not actually a tumor, but the hardened tissue puts pressure on the nerve and can increase in size the same way a tumor does. Morton’s neuroma is similar to a pinched nerve that can occur in other parts of the body.

The condition is often caused by activities that cause a lot of stress on the bottom of your feet, or wearing tight or high-heeled shoes, which is why women suffer from Morton’s neuroma more than men. 

Symptoms and Diagnosis of Morton’s Neuroma

The symptoms of Morton’s neuroma are similar to those of other foot conditions, such as arthritis and a fracture, so you’ll want a thorough exam. This exam will likely include an imaging test such as an X-ray or MRI, 

There are several ways to treat and manage Morton’s neuroma, and one of the most common procedures for the condition is surgery to remove the affected part of the nerve. This is called a neuroma excision or neurectomy (“-ectomy” means “removal”). 

A neuroma excision is an option for those with a severe neuroma, but your doctor will likely allow you to choose whether to undergo a neurectomy. The following presents the pros and cons of such a procedure.

What Are the Pros and Cons of a Neuroma Excision?

The most obvious advantage of neuroma excision is that the tissue causing pain and discomfort is being permanently removed. On average, this technique is highly successful. 

However, there are several things to consider as well:

  • Like other surgical procedures, a neurectomy requires cutting into the skin, which could cause an infection, though this is extremely rare and easily treated when discovered quickly.
  • Removing part of the nerve can cause numbness in the area. The affected area is usually so small that the numbness will barely be noticed, but in some cases the numbness could spread to a toe.
  • Your recovery period will likely include pain and swelling for up to 8 weeks. In some cases there can be pain in the area where the nerve was cut — the “stump” could attempt to regrow, forming what’s called a bulb neuroma, and an additional surgery may have to be performed.
  • Unless the entire nerve is removed, it’s possible for the condition to return.

Alternatives to Neuroma Excision

Fortunately, if your Morton’s neuroma isn’t severe, there are many non-surgical options, some of which are very easy lifestyle changes:

Change your shoes. Wearing shoes with a wider toe box, so your toes don’t feel pressed together, is the first step to finding relief. Uncomfortable high-heeled shoes, or shoes that are tight and pointy in the toe area, should be avoided. Look for dress shoes that offer adequate arch support.

Boost support with orthotics. Over-the-counter or custom shoe inserts are available in configurations that transfer weight away from the metatarsal bones (the bones in the front of the foot) to relieve pressure on the nerve, support the arch, provide cushioning, and strengthen foot muscles, tendons, and ligaments.

Consider nonsurgical treatments. In addition to the above, your doctor might recommend treatments that don’t require actual surgery. These include steroid injections (to shrink the neuroma), a series of sclerosing injections (to destroy the enlarged nerve), or physical therapy.

Contact Our NJ Orthopedic Foot Surgeon About Treating Morton’s Neuroma 

Schedule an appointment with our NJ orthopedic foot surgeon today about diagnosing and treating foot conditions including Morton’s neuroma, in addition to exploring both surgical and nonsurgical treatment options.