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Morton's neuroma: When does surgery become necessary?

While non-invasive solutions such as rest, wearing insoles, or taking anti-inflammatory drugs are initially preferred for morton's neuroma, surgery is sometimes the only way to get rid of the pain permanently. But under what conditions is going under the knife necessary? We'll decipher this in the article.

What is morton's neuroma? névrome de morton ?

Morton's neuroma is a painful condition that mainly affects the forefoot. It is a thickening of the nerve in the sole of the foot, caused by chronic compression. This nerve lesion causes significant pain and numbness. But it can also occur in people who spend a lot of time standing or walking barefoot, causing excessive friction at the front of the foot. This benign but potentially very disabling condition affects both the aesthetics of shoes and lifestyle. Let's now see in which cases surgery becomes necessary.

Non-surgical treatments

Non-surgical treatments

Before considering surgery, several conservative treatments can be implemented to try to relieve the pain caused by a morton's neuroma. We usually start with the least invasive solutions.

Rest and wearing appropriate shoes

The first step is to avoid any activity that causes pain or discomfort in the foot. Relative rest, with relief of the foot support, is recommended. It is also necessary to wear shoes that are sufficiently wide at the front, with good cushioning, to avoid compression of the forefoot.

Orthotics and insoles

To relieve the pressure on the painful area, the doctor may prescribe custom-made foot orthotics or insoles with a depression at the level of the neuroma. These devices allow the area to be cleared and friction to be avoided.

Anti-inflammatory drugs and cortisone injections

In case of significant pain, oral anti-inflammatory drugs may be advised to reduce inflammation around the neuroma. Local cortisone injections, a powerful anti-inflammatory, can also provide temporary relief.

When to consider surgery?

When to consider surgery?

If non-surgical treatments do not provide sufficient relief after several months, surgery may be necessary. Several criteria determine whether the intervention is justified. First, surgery is considered if conservative treatments fail. If, despite rest, wearing insoles, and taking medication, the pain persists and severely handicaps the patient in their daily activities, then removal of the Morton's neuroma becomes an option to seriously consider.

The patient's age and general health are taken into account by the surgeon. Surgery is not recommended for the elderly or those with healing disorders, except when absolutely necessary.

Complications and risks associated with surgery

Although relatively benign, surgical intervention to treat a morton's neuroma is not without risks. It is important to be fully aware of these before undergoing surgery.

Infectious risks

As with any invasive procedure, there is a risk of infection at the surgical wound site. That's why preventive antibiotic therapy is usually prescribed. However, despite these precautions, wound infection is always possible. Signs include significant redness around the incision, abnormal warmth, pus discharge, and fever. In this case, it is essential to seek medical attention promptly to receive appropriate antibiotic treatment orally or intravenously.

Persistent pain

One of the most frequently encountered complications after morton's neuroma removal is the persistence of residual pain despite the intervention. In about 20-30% of cases, patients continue to suffer from discomfort or pain in the operated area.

This persistent pain may have several origins. First, it is possible that a small part of the neuroma was left in place during the surgical excision. This remnant can then lead to a recurrence of symptoms after a few weeks or months.

Faced with this persistent pain, it is essential to follow the prescribed rehabilitation and not hesitate to consult again if symptoms persist. The medical teams can then propose additional solutions such as infiltrations, physiotherapy or a better adapted pain treatment.

Contact us to make an appointment with a surgeon who is an expert in the management of Morton's neuroma. Our specialists will be able to answer all your questions and accompany you in the best conditions before and after the intervention to avoid these complications.