The main goal of neuroma surgery is to remove the painful nerve that has become traumatized in-between the toes. As the nerve is being removed, it is expected that there will be permanent numbness in-between the toes. Most of the time, this sensation of numbness is preferable to the pain symptoms caused by the nerve.
Typical neuroma surgery is done in an outpatient surgical facility with IV conscious sedation. Your surgeon will most often make an incision on the top of the foot, though in some cases the incision is done from the bottom.
After surgery, walking is usually allowed immediately in a protective post-operative shoe or boot. This is used mostly to accommodate for the thick bandaging. Skin sutures are removed 2 weeks after surgery, and once removed normal bathing with foot immersion is allowed. It is normal to have “zinger-like” pains in the area of the surgery for several weeks or months afterward.
Activity after surgery will be limited, and tenderness in the ball-of-foot is expected. Your walking will be slowed down for several weeks. For exercise, a stationary bike or swimming is typically safe after the sutures have been removed. Load-style activity like walking or running is usually not comfortable until closer to 6-12 weeks post-op.
Driving is allowed almost immediately if the surgery is LEFT-SIDED, and the car is an automatic. Driving for RIGHT-SIDED feet will take anywhere from 2-6 weeks, and will depend on the individual. It is not recommended to drive while wearing the post-op shoe.
Appropriate long-term expectations from having your neuroma removed should include less pain about the ball-of-foot area. The cut-end of nerve does have the potential to become re-aggravated, trapped in scar tissue, or even to regrow into another neuroma, but these types of complications are rare.
Conservative treatment of neuromas includes offloading pads (metatarsal padding), arch supports, and/or cortisone injection therapy. Implementing these therapies can often avoid the need for surgery. Diagnostic nerve blocks are a great way to determine whether a painful nerve exists in the foot and whether it would be amenable to treatment.