Morton's Neuroma

In this painful condition one of the small nerves that supply the toes with sensation becomes swollen and scarred. As the swelling increases the nerve will be pinched with normal activity and cause severe pain in the forefoot. Curiously the pain is often intermittent and in the early stages it is difficult to localise the symptoms in the foot.

Patients are often slightly embarrassed when describing the symptoms as they are vague and it is virtually impossible to reproduce them when looking at the foot.

Surgical excision of the neuroma is used for those cases where standard treatment has been ineffective. The surgery is normally performed from an incision on top of the foot and deepened to the level of the nerve. The nerve is examined and if possible repaired, usually by the time of surgery however the damage is too great and a section of the nerve is removed. A clinical diagnosis is confirmed by sending the excised nerve tissue to the laboratory to examine it under a microscope. The wound is normally closed with dissolving stitches and steri-strips.

After surgery:-

• The foot is supported by heavy dressings of gauze, wool and crepe
• Leave dressings in place until your next out patient appointment
• DO NOT get the dressing wet or remove it
• Post-operative complication may result from wet dressings, or removal of dressings
  To heal well your foot will need rest and elevation, particularly in the first 48 hours.
• Keep the foot elevated for 48 hours - light movement is encouraged
• Elevate your foot above your hip level, one or two pillows is usually the correct height
• Use your painkillers as necessary
• Always use the post-operative shoe when mobile

When your foot settles be as active as the foot will let you.

Keep the weight away from the front of the foot until you feel comfortable.

Within a couple of days you should be able to put weight on the foot.

When a fuller understanding of the foot mechanics is necessary a full biomechanical examination or a gait analysis may be recommended. Both of these procedures can now be carried out in our practice.