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Neuroma Excision

AMBULATORY CARE:

What you need to know about neuroma excision:

Neuroma excision is surgery to remove a swollen and enlarged nerve called a neuroma, or a Morton neuroma. It usually occurs in the ball of your foot, between your third and fourth toes. The neuroma becomes pinched between toe bones and ligaments and causes pain when you walk. Surgery may be used to relieve pressure from the neuroma, or to remove it.

Foot Anatomy

How to prepare for surgery:

  • Your surgeon will tell you how to prepare for surgery. You may need to stop taking some medicines several days before surgery, such as blood thinners. Antibiotics may be given before surgery to prevent a bacterial infection. Tell your surgeon if you have ever had an allergic reaction to antibiotics or anesthesia.
  • You may be told not to eat or drink anything after midnight on the night before surgery. Your surgeon will tell you which medicines to take or not take on the day of surgery. Arrange to have someone drive you home after surgery and stay with you to make sure you are okay.

What will happen during surgery:

  • You may be given general anesthesia to keep you asleep and free from pain during surgery. You may instead be given anesthesia in your spine, leg, or foot to numb the surgery area. With this type of anesthesia, you may still feel pressure or pushing during surgery, but you should not feel any pain.
  • An incision is usually made on the top of the foot, above the neuroma. Your surgeon may need to make the incision on the bottom of your foot, but this is not common. If the neuroma will not be removed, your surgeon will only cut one of the ligaments in your foot. This should relieve the pinched nerve. If the neuroma will be removed, your surgeon will first cut the nerve that has the neuroma. Then he or she will remove it. The ligament may also be cut. The incision will be closed with stitches and covered with a bandage.

What to expect after surgery:

You may have pain and swelling for a few days after surgery. This is normal and should get better soon. You may also have areas of numbness in your toes or foot. You will be given a shoe called a postoperative shoe to wear for 2 to 3 weeks. This will protect the surgery area until the stitches are removed. You should be able to wear a regular shoe after about 3 weeks. You may need to use crutches or a knee walker to keep weight off your foot.

Risks of neuroma excision:

You may bleed more than expected during surgery or develop an infection. You may have permanent numbness in your third and fourth toes if the neuroma is removed. You may develop a blood clot in your leg or arm. A clot can break free and lead to a life-threatening stroke or heart attack.

Seek care immediately if:

  • Your foot, ankle, or leg feels warm, tender, and painful. It may look swollen and red.
  • You cannot move your foot or leg.
  • You see red streaks coming from the surgery wound.

Contact your healthcare provider if:

  • You have a fever or chills.
  • You have questions or concerns about your condition or care.

Medicines:

You may need any of the following:

  • Prescription pain medicine may be given. Ask your healthcare provider how to take this medicine safely. Some prescription pain medicines contain acetaminophen. Do not take other medicines that contain acetaminophen without talking to your healthcare provider. Too much acetaminophen may cause liver damage. Prescription pain medicine may cause constipation. Ask your healthcare provider how to prevent or treat constipation.
  • Antibiotics: This medicine is given to fight or prevent an infection caused by bacteria. Always take your antibiotics exactly as ordered by your healthcare provider. Do not stop taking your medicine unless directed by your healthcare provider. Never save antibiotics or take leftover antibiotics that were given to you for another illness.
  • Take your medicine as directed. Contact your healthcare provider if you think your medicine is not helping or if you have side effects. Tell him or her if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.

Self-care:

  • Rest often after surgery. This will help your incision wound heal.
  • Elevate your foot above the level of your heart as often as possible. This will reduce swelling and pain. Prop your leg on pillows to keep your foot elevated comfortably. The swelling should go down within about 2 weeks, but it may take 3 months for all the swelling to be gone.
  • Apply ice on your foot for 15 to 20 minutes every hour or as directed. Use an ice pack, or put crushed ice in a plastic bag. Cover it with a towel.

Activity:

  • Wear the postoperative shoe as directed for the first 2 to 3 weeks after surgery. Do not put pressure on the ball of your foot when you walk. Put your weight on your heel. Use crutches if directed.
  • Do not drive until your healthcare provider says it is okay. This will depend on which foot had the neuroma and what kind of car you drive.
  • Ask when you can return to work. You may need to wait up to 4 weeks if you have to walk or do physical activities for your job. You may be able to return to work sooner if you work at a computer or have a less active job.

Follow up with your healthcare provider as directed:

You will need to return to have your stitches removed and your incision wound checked. Write down your questions so you remember to ask them during your visits.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Further information

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