MORTON'S NEURALGIA – SURGERY
- Method
- Neurolysis or neurectomy for Morton's neuralgia in the forefoot
- Duration
- 20 to 30 minutes
- Recovery time
- 4 to 6 weeks
What is Morton's neuralgia?
Morton's neuralgia is a painful compression of a nerve in the forefoot, typically between the third and fourth metatarsal bones. It arises from pressure on the interdigital nerve, which leads to burning pain, tingling or numbness.
Surgical options
1. Neurolysis
In a neurolysis the surrounding connective tissue (for instance the intermetatarsal ligament) is released in order to give the affected nerve room again. This can often bring considerable relief of the symptoms without dividing the nerve.
- Small incision between the affected toes
- Exposure of the nerve
- Division of the neighbouring ligament to relieve the pressure
- Closure of the wound and dressing
2. Neurectomy
Where a neurolysis does not help enough, or where the nerve is already permanently damaged, a neurectomy is carried out – that is, the affected segment of nerve is removed. This switches off the conduction of pain, but also leaves a numb area of skin in the space between the toes.
- As with the neurolysis: incision and exposure of the nerve
- Division and removal of the affected part of the nerve
- Burying the nerve stump deeper to avoid pain
- Closure of the wound
Rehabilitation after Morton's neuralgia surgery
Phase I (0-2 weeks): protection and wound healing
- Forefoot offloading shoe for 10-14 days
- Elevation and cooling to reduce swelling
- Wound checks and changes of dressing
- Thrombosis prophylaxis while mobility is reduced
Phase II (3-5 weeks): building up load
- Changing to comfortable everyday footwear
- Physiotherapy to encourage mobility
- Gait training and co-ordination training
- Returning to everyday tasks
Phase III (from week 6): return to full capacity
- Full weight-bearing without restriction
- Sporting activities once medically cleared
- Long-term insoles where needed to avoid pressure