SURGICAL TREATMENT
Outpatient or hospital stay: Almost always outpatient (home same day)
Type of anaesthesia: May be regional or general, or a combination
Length of surgery: 1-2 hours
Recovery time: 8 weeks for normal walking, up to 9 months for vigorous activity

Surgery removes the inflamed nerve, involving identifying the nerve and resecting (cutting) the neuroma. After surgical removal of the neuroma and the injured nerve, the space between the two toes is expected to be numb. This can be done through an incision on the top (dorsal incision) or on the sole of the foot (plantar incision).

RECOVERY

Following surgery:

  • You will have a bandage or dressing to protect the incision.
  • You will be instructed on caring for your dressings, and if and how much weight you can bear on the foot.
  • Keep your dressings dry (place a plastic bag on your foot when showering).
  • Watch for complications. Alert your surgeon or visit an emergency room if you experience bleeding that won’t stop, pain that does not subside with prescribed medication, swelling that worsens (or dressings that become too tight – remove them, but visit an emergency room immediately following) after the second day, drainage from the wound, and/or have a fever higher than 38°C or 101°F.

Potential operative complications include:

  1. Delayed healing. It is not unusual for mild residual swelling at the surgical site to cause persistent discomfort for 2-3 months. Occasionally up to 6 months.
  2. Infection as with any surgical procedure
  3. Post-operative scar tissue can be quite uncomfortable, especially if the incision is made on the plantar aspect of the foot.
  4. Stump Neuroma. Where the nerve regrows where it has been cut causing recurrence of symptoms.
  5. Continued pain. This is not uncommon as the nerve maybe only a part of the pain generating complex.

About 10 to 14 days after surgery, the dressing and sutures will be removed at a post-operative appointment determined by your surgeon, and you can participate in some exercise programs. In general, pleasure walking, swimming, using an elliptical and stationary biking are acceptable. Sports like tennis or running and other exercises that place a large amount of pressure on the toes, or involve sudden stops, are not advised for at least 6 to 9 months. You will be able to wear a stiff-soled sandal or shoe 6 to 8 weeks following surgery, but swelling may take up to 12 months to completely subside.