Peripheral Nerve Surgery
Surgical treatment of the nerves supplying the foot, including decompression, repair and neuroma management.
Key Takeaways
- Peripheral nerve surgery treats compression, injury and painful neuromas.
- It is considered when medication has failed to control nerve pain adequately.
- A neuroma is a painful nerve ending that forms after injury or amputation.
- Careful patient selection is what separates good outcomes from disappointing ones.
What Problems Can Nerve Surgery Address?
- Entrapment: releasing a compressed nerve at a narrow tunnel
- Neuroma: treating a painful nerve ending, common after amputation
- Nerve injury: repairing a nerve damaged during trauma or previous surgery
- Refractory nerve pain: selected cases where medication is insufficient
What Is a Neuroma and Why Does It Hurt?
Neuroma: a disorganised bundle of nerve fibres that forms at the cut or injured end of a nerve, producing sharp, localised pain.
When a nerve is cut, the fibres attempt to regrow. Where they cannot reach their destination, they coil into a sensitive knot. Pressing it produces an electric, shooting pain, which patients often describe as far worse than the original problem. This is a recognised issue after toe or partial foot amputation.
How Are Neuromas Treated?
Padding and footwear modification come first, alongside medication and injections. Where these fail, surgery relocates the nerve end into muscle or bone, away from pressure. Relocation works considerably better than simply cutting the neuroma out, since a new one otherwise forms in the same place.
Who Is a Good Candidate?
Patients with well localised pain that reproduces on pressing one specific point, adequate circulation, and pain that has not responded to conservative treatment over several months. Conversely, generalised burning across the whole foot is neuropathy, and surgery does not address that.
Assessment always includes circulation testing through our vascular service, because healing depends on it.
What Does It Cost and What Should You Expect?
Costs vary with the procedure and are quoted after assessment. Expect gradual improvement rather than immediate resolution, since nerves settle slowly, and expect us to be candid if we think surgery is unlikely to help you.