A neuroma, sometimes known as Morton’s neuroma is a fibrous thickening of a nerve in the front of the foot. The correct title for a neuroma is a perineural fibrosis. Neuromas can be found in between any of the long bones of the forefoot (metatarsals) yet commonly occur between the 3rd and 4th metatarsals. They occur due to friction or compression on the effected nerve perhaps from tight shoes or flat feet.
Pain is often felt in the ball of the foot as a burning or aching sensation which may have shooting pains towards the associated toes. Pain maybe increased by tight shoes or certain sports. Diagnosis is often made by clinical examination and an ultrasound examination.
Neuroma treatment consists of three alternatives. Firstly orthotics and shoe wear modification, if unsuccessful then corticosteroid injections can be attempted. If these prove unsuccessful then surgery can be carried out. Surgery is done as a day care basis in an accredited hospital and usually under general anaesthetic which is carried out by a medically trained specialist anaesthetist. A small incision is commenced on top of the offending inter-metatarsal space and taking great care not to damage the surrounding tissues the offending enlarged nerve is removed and the area sutured. A compressive dressing is applied and a post-op shoe is used.
Stitches are removed at two weeks and return to a deep wide shoe can commence soon after with return to normal footwear occurring in the following weeks. Post-op pain is controlled completely in most cases.
Foot surgery has markedly advanced and the likelihood of complications are also markedly reduced; yet complications may still occur and there is a very slim chance the neuroma may return.