A MORTON'S NEUROMA DOCTOR COMPLETE GUIDE TO MORTON’S NEUROMA SURGERY

What is Morton's Neuroma?

Morton's Neuroma is a painful growth of nerve tissue in the foot, most commonly found between the heads of the third and fourth metatarsals, the long bones in your feet. When your metatarsals in your feet compress together because of either foot deformities, high-impact activities, or the use of tight shoes such as heels, the nerves between the metatarsals become irritated and swollen. The thickening of nerve tissue can result in pain in the ball of the foot, numbness in the toes, and the constant sensation of walking on a pebble. If left untreated, this condition can result in long-term nerve damage and become extremely painful.

Our NYC foot doctors at Gotham Footcare can treat Morton’s Neuroma in less than 20 minutes. Our painless, minimally invasive procedure eliminates the neuroma and allows you to resume regular physical activity in days with minimal to no postoperative pain.

What are the symptoms of Morton's Neuroma?

If you have Morton’s Neuroma, you may experience the following symptoms:

• Numbness of the toes (typically the third and fourth toes)
• Burning sensation radiating into the toes.
• Tingling sensation radiating into the toes.
• Sensation of walking on a pebble

What Causes Morton’s Neuroma?

• Tight Shoes. Wearing high-heeled shoes or shoes that are ill fitting and tight can lead to irritation and swelling in the nerves of your feet.
• High Impact Activities. Participating in athletic activities that involve running or jumping may subject your feet to repetitive trauma. Sports that involve tight shoes, such as cycling or rock climbing, can put pressure on the nerves of your feet.
• Foot deformities. People who suffer from bunions, hammertoes, high arches or flatfeet are at higher risk of developing Morton's neuroma.

How do you treat Morton’s Neuroma? What causes a Morton’s Neuroma flare up?

Most treatments for Morton’s Neuroma involve conservative, non-surgical modalities centered on relieving foot pain and healing the nerve.

Conservative treatment options include:

• Anti-inflammatory medications
• Steroid injections
• Physical therapy
• Shockwave Therapy

How do you shrink Morton’s Neuroma?

Steroid injections are anti-inflammatory cortisone medications administered every six to eight weeks to reduce inflammation of a neuroma. Steroid injections can help provide temporary relief of symptoms in the early stages of a neuroma; they are less effective in chronic cases of neuroma pain lasting 1 year or more.

How do you treat Morton's Neuroma naturally?

• Ice the affected area to reduce pain and inflammation
• Wear wide shoes
• Wear custom molded orthotics
• Wear Toe Spacers (Correct Toes) at night
• Wear Toe Socks
• Wear neuroma padding to offload pressure to the affected nerve

What shoes should I wear for Morton’s Neuroma?

If you suffer from Morton’s Neuroma wear shoes that have the following features:

• Appropriately sized
• Wide toe box
• Thick rubber sole for shock absorption
• Adequate arch support
• Very low or zero drop shoes to reduce forefoot pressure and body weight

Shoe recommendations for Morton’s Neuroma include:

• Hoka One One Bondi 7
• Brooks Addiction Walker
• Asics Gel-Cumulus Running
• Orthofeet Sanibel Mary Jane
• Dansko Sandals in wide widths

Are Toe Spacers (Correct Toes or YogaToes) effective for Morton’s Neuroma?

Yes. Toe spacers help reduce nerve compression and irritation by increasing the volume and space between the toes. Toe spacers are also effective at resetting the foot's natural biomechanics to reduce Morton's Neuroma pain.

Should you massage Morton's Neuroma?

Yes. Most people who suffer from Morton’s Neuroma pain find relief of symptoms by gently massaging their feet daily.

Is walking good for Morton’s Neuroma?

Walking for long periods of time may aggravate your neuroma by increasing pain and inflammation.

Does losing weight help Morton's neuroma?

Yes. Losing weight does reduce the amount of pressure placed onto the foot which can help reduce Morton’s Neuroma pain and inflammation.

Does Morton’s Neuroma show up on X-ray?

An X-ray will not show a neuroma. However, an x-ray can help rule out other conditions such as arthritis or a metatarsal stress fracture that may contribute to the formation of a neuroma. Most of the time, your doctor can diagnose a Morton's neuroma based on your symptoms and a physical exam. Your doctor may require an ultrasound or MRI to confirm the diagnosis.

What is the best treatment for Morton’s Neuroma?

At Gotham Footcare, we offer patients Cryosurgery, a highly effective and minimally invasive office-based procedure that requires no stitches and only takes 15 minutes to perform.

Do Morton’s Neuromas go away on its own?

This condition is not life-threatening. Symptoms may come and go, depending on the activities that you perform and the types of shoes you wear. However, Morton's Neuroma pain does not resolve or disappear on its own.

What happens if Morton’s Neuroma goes untreated?

Long-term complications of a neuroma include loss of sensation in the toes and permanent nerve damage.

Should I have Morton’s Neuroma Surgery?

Surgery for Morton’s Neuroma should only be considered when conservative treatment fails. Cryosurgery is the most effective minimally invasive surgical treatment option available for Morton’s Neuroma with a success rate of over 85%. The traditional surgical approach for Morton’s Neuroma is called a neurectomy, which involves surgically removing the neuroma. A neurectomy should be the very last resort for treating Morton’s Neuroma as this procedure has a high risk of failure and postoperative complications.

What is Cryosurgery (Cryoablation) for Morton’s Neuroma?

Cryosurgery does not involve nerve cutting. This type of procedure involves cyclically freezing the neuroma to degenerate the unhealthy tissue that carries painful impulses to the brain through a process called Wallerian degeneration. By restoring the nerve to a healthy state, cryosurgery helps reduce sensitivity, inflammation, and irritation of the nerve. Cryosurgery stops the pain of Morton’s neuroma and allows patients to return to their activities of daily living free of pain.

What is Neuroma Surgery (Neurectomy):

A Neuroectomy surgery involves surgically excising the painful neuroma. This procedure should be the last resort for treatment of a neuroma as removing the nerve can result in the formation of a post surgical Stump Neuroma, as the remaining portion of the nerve regrows into scar tissue. A stump neuroma can be more painful than the neuroma itself. A neurectomy also has a 20% failure rate which means that one out of every five patients develop a Stump Neuroma.

Should I have Morton’s Neuroma Surgery?

Surgically excising a neuroma (neurectomy) can result in the formation of a stump neuroma. Cryosurgery is recommended prior to having a neurectomy as this procedure does not involve cutting of the nerve. Cryosurgery for Morton’s Neuroma is minimally invasive, low risk, and has an 85% success rate. Cryosurgery can also be repeated if necessary.

The advantages of Cryosurgery:

• High Success Rate of 85%
• Low Risk
• Minimally Invasive
• Minimal Recovery (immediate weight Bearing without crutches or cast required)
• Minimal To No Discomfort
• No Stump Neuroma Formation
• Treatment Can Be Repeated

Minimally Invasive Nerve Decompression

Cryosurgery can be performed along with a minimally invasive procedure to isolate and cut the deep transverse metatarsal ligament, a ligament that compresses the metatarsals together and contributes to the formation of a neuroma. Minimally invasive nerve decompression allows a precise, predetermined cut of the ligament to be made through a small incision while protecting the surrounding tissue from damage. At Gotham Footcare, our surgeons offer patients suffering from Morton’s Neuroma, the benefits of minimally invasive surgery in the convenience of a minor surgery setting.

What to expect of Cryosurgery for Morton’s Neuroma:

• Your doctor will use ultrasound imaging (the same non-invasive technology used to see babies in the womb) to visualize and identify the specific location of the nerve.
• Then the doctor will numb the area with a local anesthetic, gently insert a Cryoablation probe to safely freeze the nerve using ultrasound imaging.
• After cyclically freezing the neuroma, decompression of the scar tissue surrounding the nerve is performed by releasing the deep transverse metatarsal ligament that holds the metatarsal head together. A stitch is then applied to the incision site.
• A dry, sterile, compressive dressing will be applied to your foot along with a walking post operative shoe. Casts or crutches are not required after the surgery and you can return to your pre-procedure life with reduced activity. It can take up to 16 weeks for the full effect of the cryoablation procedure and nerve decompression to occur.
• You will be able to go home immediately after the procedure is completed.
• Patients treated with cryosurgery and minimally invasive nerve decompression have minimal postoperative pain during the recovery phase. You may experience some mild numbness, bruising, or swelling on the top of your foot which will resolve in a few weeks. Repeating the procedure may be necessary if symptoms do not resolve.

How can I cure my Morton’s Neuroma?

If you are experiencing the symptoms of Morton's Neuroma for more than 3 days, see a podiatrist immediately. Morton’s neuroma could cause permanent loss of sensation in your foot affecting your ability to fully engage in many activities. Morton’s neuroma can be a difficult condition to treat if not treated appropriately. Conservative treatment can be effective at reducing Morton’s Neuroma pain especially when slight alterations are also made to your lifestyle such as wearing more comfortable shoes. However, in some cases when Morton’s Neuroma pain is chronic and conservative treatment fails to reduce pain and discomfort, cryosurgery may be necessary.

How much does Morton’s Neuroma surgery cost in NYC?

Cryosurgery is covered by most insurance companies. Our surgical coordinator can run your benefits to confirm the coverage of your plan prior to scheduling.

At Gotham Footcare, our award-winning podiatrists offer a wide array of options including Cryosurgery, a quick, painless, and minimally invasive procedure that effectively eliminates Morton’s Neuroma. If you want relief from your Morton’s neuroma, visit our Midtown or Downtown Manhattan offices, by calling (212) 921-7900, emailing us at [email protected] or booking your appointment directly on our website www.gothamfootcare.com