You are in the right place. Dr. Tom Biernacki, DPM, FACFAS — board-certified foot & ankle surgeon with 3,000+ surgeries — explains exactly what neuroma surgery / neurectomy recovery means and what actually works. Call (810) 206-1402 for a same-day appointment at our Howell or Bloomfield Hills office.
The most important clinical decision with Neuroma Surgery Neurectomy Recovery isn’t which treatment to start with — it’s identifying the correct subtype. That changes everything. Call (810) 206-1402.
Dr. Tom’s Top Bob and Brad Massage Guns (2026)
Medically reviewed by Dr. Tom Biernacki, DPM
Board-certified podiatric surgeon | Balance Foot & Ankle
Last reviewed: May 2026
Affiliate disclosure: As an Amazon Associate, Balance Foot & Ankle earns from qualifying purchases. Bob and Brad are physical therapists whose products I trust for self-care between visits.
Dr. Tom’s Top Pain Relief Picks — Dr. Hoy’s (2026)
Affiliate disclosure: As an Amazon Associate, Balance Foot & Ankle earns from qualifying purchases. I personally use Dr. Hoy’s in my practice for patients who need topical relief.
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Medically reviewed by Dr. Tom Biernacki, DPM · Board-Certified Podiatric Surgeon · Last reviewed: April 2026 · Editorial Policy
Related Conditions
Quick Answer
Neuroma Surgery: Neurectomy, Decompression, Recovery, and Wh relates to Morton’s neuroma — typically caused by nerve compression between toes. Most patients improve in 8-12 weeks conservative with conservative care. Same-week appointments in Howell + Bloomfield Hills: (810) 206-1402.
Medically reviewed by Dr. Tom Biernacki, DPM — Board-certified foot & ankle surgeon, 3,000+ surgeries performed. Updated April 2026 with current clinical evidence. This article reflects real practice experience from Balance Foot & Ankle Specialists in Howell and Bloomfield Hills, Michigan.
Quick Answer
Morton’s neuroma is a thickening of nerve tissue between the third and fourth toes causing burning pain, numbness, or the sensation of a pebble under the ball of the foot. Wide toe-box shoes with a metatarsal pad resolve 70% of cases; the rest benefit from cortisone or sclerosing injections.
Watch: Dr. Tom Biernacki, DPM
✅ Medically reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatrist · Last updated April 6, 2026
Neuroma Surgery: Neurectomy, Decompression, Recovery, and What to Expect
What Is Neuroma Surgery?
Neuroma surgery — most commonly performed for Morton neuroma — removes or decompresses an enlarged, irritated nerve between the metatarsal bones of the forefoot. Morton neuroma typically affects the nerve between the third and fourth toes, causing burning, shooting pain, and the sensation of standing on a pebble. Surgery is considered after conservative treatment fails to provide adequate relief.
When Is Surgery Recommended?
Most neuromas are successfully managed without surgery. Wider shoes, metatarsal pads, custom orthotics, and corticosteroid injections resolve symptoms in the majority of patients. Surgery becomes the next step when pain persists despite 3 to 6 months of conservative care, when diagnostic injections confirm the neuroma as the pain source, and when imaging (ultrasound or MRI) documents nerve enlargement consistent with symptoms.
Neurectomy: The Standard Procedure
The most common surgical approach is neurectomy — complete removal of the affected nerve segment. The surgeon accesses the nerve either from the top of the foot (dorsal approach) or the bottom (plantar approach). The dorsal approach allows earlier weight-bearing because the incision is not on the weight-bearing surface, but visualization is slightly more limited. The plantar approach offers better direct visualization but requires more careful wound protection during healing.
The nerve is identified, traced proximally, and excised. A portion of the proximal nerve stump is buried in muscle to reduce the risk of stump neuroma formation. The excised tissue is sent for pathological analysis to confirm diagnosis.
Nerve Decompression as an Alternative
Some surgeons prefer nerve decompression — releasing the transverse metatarsal ligament that lies above the nerve — rather than excision. This approach preserves the nerve and avoids permanent numbness in the affected toe cleft. Results from decompression are generally good, with some series reporting outcomes comparable to neurectomy, and it leaves the option for neurectomy available if needed later.
Recovery After Neuroma Surgery
Neuroma surgery is performed as outpatient surgery under local anesthesia with sedation. With the dorsal approach, many patients walk immediately in a post-operative shoe. Pain and swelling are common in the first 2 weeks. Return to regular shoes is typically possible at 4 to 6 weeks. Full recovery, including complete resolution of surgical swelling and any residual sensitivity, takes 3 to 6 months.
Permanent numbness between the affected toes is expected after neurectomy — the nerve has been removed. Most patients find this preferable to the pre-surgical burning pain, but it is important to understand before surgery that some sensation change is permanent and intended.
Risks and Complications
The most significant complication is stump neuroma — a painful regrowth of nerve tissue at the cut end. This can cause symptoms similar to or worse than the original neuroma and may require additional surgery. Infection, scar tenderness, incomplete relief, and transfer of symptoms to adjacent nerve spaces are other possible outcomes. Success rates for neurectomy in carefully selected patients range from 75 to 85 percent in published series.
Alcohol Sclerosing Injections as a Non-Surgical Alternative
A series of ultrasound-guided alcohol sclerosing injections can shrink and deaden the neuroma without surgery. Multiple injections spaced 7 to 10 days apart are required, and results vary, but some patients achieve sustained relief that avoids surgery entirely. This option is worth discussing with your podiatrist before committing to excision.
Questions to Ask Before Surgery
Before scheduling neuroma surgery, confirm the diagnosis with a diagnostic injection, ask about the approach (dorsal vs. plantar) and the reasoning, understand what permanent changes to expect in sensation, inquire about the surgeon is volume of neuroma procedures, and ask about outcomes data and revision surgery rates at their practice.
Stump Neuroma: When Neuroma Recurs After Surgery
The most significant complication specific to Morton’s neurectomy is stump neuroma — a new, painful neuroma forming at the proximal end of the resected nerve. When the nerve is cut, the proximal stump naturally attempts axonal regeneration, and if this regenerating nerve end encounters scar tissue, mechanical pressure, or inflammatory stimulation, it can develop into a new neuroma at the resection site. Stump neuromas are typically more challenging to treat than the original Morton’s neuroma because the scarring from the initial surgery complicates subsequent dissection.
Prevention is the most effective strategy: ensuring adequate proximal resection length during the initial neurectomy (leaving the stump in fat tissue well away from weight-bearing pressure, not in the immediate forefoot region) significantly reduces stump neuroma incidence. When stump neuroma does develop, treatment options include ultrasound-guided alcohol sclerosing injections, surgical re-excision with more proximal nerve resection, and nerve end burial into bone or muscle to prevent regeneration into a compressed scar. Accurate diagnosis of stump neuroma requires distinguishing it from scar tissue pain and residual or recurrent interdigital neuroma — diagnostic ultrasound by an experienced sonographer is the key imaging tool. At Balance Foot & Ankle in Howell and Bloomfield Hills, we evaluate and manage both primary Morton’s neuroma and stump neuroma complications from prior procedures.
Related Treatment Guides
- Custom 3D Orthotics
- Morton’s Neuroma Treatment
- Plantar Fasciitis & Heel Pain Treatment
- Sports Foot & Ankle Injury Treatment
Michigan patients experiencing foot or ankle problems can schedule an appointment at Balance Foot & Ankle — with locations in Howell (4330 E Grand River) and Bloomfield Hills (43494 Woodward Ave #208). Call (810) 206-1402 for same-week availability.
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Howell Office
4330 E Grand River Ave
Howell, MI 48843
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Bloomfield Hills Office
43494 Woodward Ave, #208
Bloomfield Hills, MI 48302
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Same-week appointments available at both locations.
In-Office Treatment at Balance Foot & Ankle
If home care isn’t resolving your Morton’s neuroma, a visit with a board-certified podiatrist is the fastest path to accurate diagnosis and a personalized plan. At Balance Foot & Ankle Specialists, Dr. Tom Biernacki, Dr. Carl Jay, and Dr. Daria Gutkin offer same-day and next-day appointments at both our Howell and Bloomfield Hills offices. We perform on-site diagnostic ultrasound, digital X-ray, conservative care, advanced regenerative treatments, and minimally invasive surgery when indicated.
Call (810) 206-1402 or request an appointment online. Most insurance plans accepted, including Medicare, Blue Cross Blue Shield, Aetna, Cigna, and United Healthcare.
Differential Diagnosis: What Else Could It Be?
Several conditions share symptoms with Morton’s Neuroma and are commonly misdiagnosed in the first office visit. Considering these alternatives is part of every Balance Foot & Ankle exam:
- Capsulitis (2nd MTP). Pain at 2nd-toe base rather than between toes; drawer test positive.
- Stress fracture. Single-point tenderness over a metatarsal shaft, not between toes.
- Freiberg’s infraction. AVN of metatarsal head, classic radiograph flattening.
If your symptoms don’t fit the textbook pattern, ask your podiatrist which differentials they ruled out — that conversation often shortcuts months of trial-and-error treatment.
In Our Clinic
The classic Morton’s neuroma patient in our clinic is a 40- to 60-year-old woman who describes burning or “walking on a marble” in the 3rd intermetatarsal web space, often worsening in narrow or high-heeled shoes. We confirm with a Mulder’s click test (sometimes supplemented by ultrasound). The first line of treatment is always a metatarsal pad placed PROXIMAL to the neuroma + a wide-toe-box shoe. Many patients improve just from that — we don’t reach for injections or surgery right away. When conservative care fails after 6–12 weeks, a single corticosteroid or alcohol sclerosing injection is our next step.
Most Common Mistake We See
The most common mistake we see is: Adding a cushioned insole instead of a metatarsal pad. Fix: place the metatarsal pad PROXIMAL to (behind) the metatarsal heads — not directly under them.
Warning Signs That Need Same-Day Care
Seek immediate evaluation at Balance Foot & Ankle if you experience any of the following:
- Point tenderness on a single metatarsal suggesting stress fracture
- Unable to bear weight
- Progressive numbness up the foot
- Visible deformity or cross-over toe
Call (810) 206-1402 — same-day and next-day appointments at our Howell and Bloomfield Hills offices.
More Podiatrist-Recommended Neuroma Essentials
Wide Neutral Cushion Shoe
New Balance 1080 V14 — max forefoot room decompresses the pinched nerve.
Wide-Toe-Box Walking Shoe
New Balance 990v6 — prevents the forefoot compression that triggers Morton’s neuroma.
Orthotic with Met Pad Built-In
PowerStep Pinnacle — arch support reduces nerve irritation between metatarsals.
As an Amazon Associate, Balance Foot & Ankle earns from qualifying purchases. Product recommendations are based on clinical experience; prices and availability shown above update live from Amazon.
When to See a Podiatrist
A Morton’s neuroma that doesn’t respond to metatarsal pads and wider shoes within 6-8 weeks usually needs a cortisone injection or — for stubborn cases — alcohol sclerosing or nerve decompression. Balance Foot & Ankle diagnoses neuromas with in-office ultrasound and treats them without surgery in most cases. Don’t keep walking on a burning, tingling forefoot — the nerve irritation compounds the longer it’s untreated.
Call Balance Foot & Ankle: (810) 206-1402 · Book online · Offices in Howell & Bloomfield Hills
Pros & Cons of Conservative Care for foot care
Advantages
- ✓ Conservative care first
- ✓ Same-week appointments
- ✓ Multiple insurance accepted
Considerations
- ✗ Self-treatment can mask issues
- ✗ See a podiatrist if pain >2 weeks
In This Article
- Quick Answer
- In-Office Treatment at Balance Foot & Ankle
- Differential Diagnosis: What Else Could It Be?
Several conditions share symptoms with Morton’s Neuroma and are commonly misdiagnosed in the first office visit. Considering these alternatives is part of every Balance Foot & Ankle exam:Capsulitis (2nd MTP). Pain at 2nd-toe base rather than between toes; drawer test positive.
Stress fracture. Single-point tenderness over a metatarsal shaft, not between toes.
Freiberg’s infraction. AVN of metatarsal head, classic radiograph flattening.If your symptoms don’t fit the textbook pattern, ask your podiatrist which differentials they ruled out — that conversation often shortcuts months of trial-and-error treatment.
In Our Clinic
The classic Morton’s neuroma patient in our clinic is a 40- to 60-year-old woman who describes burning or “walking on a marble” in the 3rd intermetatarsal web space, often worsening in narrow or high-heeled shoes. We confirm with a Mulder’s click test (sometimes supplemented by ultrasound). The first line of treatment is always a metatarsal pad placed PROXIMAL to the neuroma + a wide-toe-box shoe. Many patients improve just from that — we don’t reach for injections or surgery right away. When conservative care fails after 6–12 weeks, a single corticosteroid or alcohol sclerosing injection is our next step.Most Common Mistake We See
- Warning Signs That Need Same-Day Care
- Frequently Asked Questions
Dr. Tom’s Recommended Products for foot care
Affiliate disclosure: As an Amazon Associate, Balance Foot & Ankle earns from qualifying purchases. We only recommend products we use with patients.
Footnanny Heel Cream Dr. Tom’s Pick
Best for: Daily moisturizer for cracked heels
Ready to Get Back on Your Feet?
Same-day appointments in Howell + Bloomfield Hills. Most insurance accepted. Dr. Tom Biernacki, DPM & team.
Book Today — Same-Day Appointments Available
Call Now: (810) 206-1402
About Your Care Team at Balance Foot & Ankle
Dr. Tom Biernacki, DPM · Board-Certified Foot & Ankle Surgeon. Specializes in conservative-first care, minimally invasive bunion surgery, and complex reconstruction.
Dr. Carl Jay, DPM · Accepting new patients. Specializes in sports medicine, athletic injuries, and routine podiatric care.
Dr. Daria Gutkin, DPM, AACFAS · Accepting new patients. Specializes in surgical reconstruction and pediatric podiatry.
Locations: 4330 E Grand River Ave, Howell, MI 48843 · 43494 Woodward Ave Suite 208, Bloomfield Hills, MI 48302
Hours: Mon–Fri 8:00 AM – 5:00 PM · (810) 206-1402
Dr. Tom’s Top 3 — The Premium Foot Pain Stack (2026)
If you only buy three things for foot pain, get these. PowerStep + CURREX orthotics correct the underlying foot mechanics, and Dr. Hoy’s pain gel delivers fast topical relief. This is the exact stack Dr. Tom Biernacki, DPM gives his Michigan podiatry patients on visit one — over 10,000 patients have used this exact combination.
Dr. Tom Biernacki, DPM is a board-certified podiatrist + Amazon Associate. Picks shown are products he prescribes to patients at Balance Foot & Ankle Specialists. We earn a commission on qualifying purchases at no extra cost to you. All products independently tested + reviewed for 30+ days minimum. Last verified: April 28, 2026.
PowerStep Pinnacle MaxxDr. Tom’s #1 Brand
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Dr. Tom’s most-prescribed OTC orthotic. Lateral wedge corrects overpronation that causes 90% of foot pain. Deep heel cradle stabilizes the ankle. Built by podiatrists, used by patients worldwide.
- Lateral wedge corrects pronation
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- Trim-to-fit any shoe
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- Trim-to-size required
- 5-7 day break-in for some
This single insole eliminates plantar fasciitis pain in 60% of patients within 2 weeks. The lateral wedge is the active ingredient — it stops the overpronation that causes the fascia to overstretch with every step. Pair with a max-cushion shoe for compound effect.
CURREX RunProDr. Tom’s #1 Brand
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3 arch heights for custom fit (Low/Med/High). Carbon-reinforced heel + dynamic forefoot — the closest OTC orthotic to a $500 custom orthotic. Engineered in Germany.
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Choose your arch height from a wet-foot test (low/med/high). Wrong arch = re-injury. For runners, athletes, or anyone who failed standard insoles — this is the closest you can get to custom orthotics without paying $500. The carbon heel is what professional athletes use.
Dr. Hoy’s Natural Pain Relief GelDr. Tom’s #1 Brand
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Menthol-based natural pain relief — Dr. Tom’s #1 brand for fast relief without greasy residue. Safe for diabetics + daily use. Cleaner formula than Voltaren or Biofreeze.
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Apply to plantar fascia + calves before bed. Combined with stretching, eliminates morning fascia pain. The clean formula means you can use it daily long-term — Voltaren has 30-day limits, Dr. Hoy’s doesn’t.
Doctor Hoy’s Natural Pain Relief Gel
Natural topical pain relief I use in our clinic. Arnica + camphor formula — apply directly to the area 3–4x daily. ($20–25)
Frequently Asked Questions
What does a Morton’s neuroma feel like?
Patients most often describe it as walking on a pebble or a bunched-up sock — a burning, aching pressure between the third and fourth toes. Some feel an electric shock-like sensation that radiates into the adjacent toes. The pain typically worsens in narrow shoes and improves when barefoot or in wide, low-heeled footwear. This shoe-dependent pattern is the hallmark — if removing your shoes relieves your forefoot pain within minutes, a neuroma is the most likely diagnosis.
What causes a Morton’s neuroma?
A neuroma forms when the digital nerve running between the metatarsals becomes compressed and irritated, leading to perineural fibrosis (scar tissue thickening around the nerve). Common causes: narrow footwear that compresses the forefoot, high heels that shift body weight to the metatarsals, foot deformities (bunions, hammer toes, flat feet) that alter metatarsal spacing, and high-impact repetitive activity. Women develop neuromas 8–10 times more often than men, largely due to footwear choices.
Can a Morton’s neuroma go away without treatment?
Mild neuromas occasionally resolve with footwear changes alone — switching to wide, low-heeled shoes removes the compression causing symptoms. However, once a neuroma has been symptomatic for 6+ months, the nerve thickening is usually permanent without active intervention. Conservative treatment (footwear, metatarsal pads, steroid injections) resolves symptoms in 50–70% of patients. Surgery (neurectomy) has a 75–85% success rate for cases that don’t respond to conservative care.
Does a Morton’s neuroma require surgery?
Only when conservative options have failed. The escalation: wide-toe-box shoes + metatarsal pads → corticosteroid injection (works in 40–60%) → ultrasound-guided alcohol sclerosing injections (70–80% success) → surgical neurectomy. Surgery involves removing the thickened nerve segment under local anesthesia with a short recovery (2–4 weeks). The trade-off: permanent numbness in the web space between the affected toes. Most patients consider this acceptable given significant pain resolution.
How is a Morton’s neuroma diagnosed?
Clinical diagnosis is most common — the history and Mulder’s test (side-to-side metatarsal compression that recreates pain or a palpable click) identify the majority of cases. Ultrasound confirms the diagnosis and measures neuroma size — this helps predict treatment response; small neuromas (<5mm) respond well to injections, large ones (>8mm) often need surgery. MRI is reserved for atypical cases where a ganglion cyst, bursitis, or stress fracture may be mimicking a neuroma.
Can I run with a Morton’s neuroma?
Often yes, with the right footwear. Switching to wide-toe-box running shoes (Altra, Hoka with wide forefoot) with a metatarsal pad placed just proximal to the 3rd–4th interspace reduces compression during running. Reduce mileage temporarily. If pain exceeds 4/10 during a run, the nerve is being compressed and stop — continuing through moderate pain causes further fibrosis. Most runners with neuromas can return to full training after 4–8 weeks of proper shoe and pad adjustment.
Can both feet have neuromas at the same time?
Yes — bilateral neuromas occur in about 15–20% of neuroma patients, most commonly in women with a history of prolonged narrow-shoe wear. Multiple neuromas in the same foot (double neuroma) are less common but occur. When both feet are symptomatic, we typically treat the more painful side first to assess response before proceeding to the other foot. The treatment approach is the same bilaterally.
What shoes are best for Morton’s neuroma?
Wide, deep toe box is the top priority — enough room that the metatarsal heads aren’t compressed at all. Low heel (under 1 inch) to minimize forefoot load. Firm, cushioned forefoot. Best performers: Altra Torin, Hoka Bondi (wide toe box version), New Balance 574/993, Brooks Adrenaline wide. The test: you should be able to wiggle all toes freely with the shoe on. If the forefoot feels snug, the shoe is compressing the neuroma.
What is a metatarsal pad and does it help neuromas?
A metatarsal pad placed proximal to (just behind) the 3rd–4th metatarsal heads spreads those metatarsals apart, decompressing the interdigital nerve. It’s one of the most cost-effective interventions — $5–15 for OTC pads, significant relief for 50–60% of patients when placed correctly. Placement is everything: the pad goes behind the metatarsal heads, not under them. We fit them in-office to confirm position. Incorrectly placed pads (under the heads) increase compression and worsen symptoms.
Are corticosteroid injections safe for Morton’s neuroma?
Yes — for short-term pain relief. Ultrasound-guided cortisone injections reduce inflammation and perineural swelling, resolving symptoms in 40–60% of patients for 3–12 months. We limit to 2–3 injections per neuroma; repeated injections can cause fat pad atrophy and skin depigmentation. If 2 injections don’t produce lasting relief, alcohol sclerosing injections (3–5 treatment series, 70–80% success) or surgery is the next step. Injections are office-based, take 5 minutes, and are covered by most insurance plans.
Get Expert Care at Balance Foot & Ankle
Same-week appointments at our Howell and Bloomfield Hills offices. Board-certified podiatric surgeons. Most insurance accepted.
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Dr. Tom Biernacki, DPM is a board-certified foot & ankle surgeon (ABFAS & ABPM) at Balance Foot & Ankle Specialists in Southeast Michigan. With over a decade of clinical experience, he specializes in heel pain, bunions, diabetic foot care, sports injuries, and minimally invasive surgery. Dr. Biernacki is a member of the APMA and ACFAS, and his patient education content on MichiganFootDoctors.com and YouTube has made him one of the most-followed foot & ankle educators on YouTube.