What Is Nerve Surgery (Neurolysis)

Compressed nerves can become enlarged and be very painful, but neurolysis, or nerve surgery, can treat the condition and relieve any pain or discomfort. Inflamed nerve tissues are referred to as neuromas and commonly form on the ball of the foot between the third and fourth or the second and third toes as a result of injury or trauma. Your doctor can perform either neurolysis or nerve surgery to treat a neuroma. Neurolysis involves hardening the nerve while surgery involves either removing the affected nerve tissue or reducing pressure on the nerve.

Reasons for nerve surgery

Nerve surgery is performed to relieve the pain and discomfort associated with a neuroma. In most cases, these procedures are considered only if other treatments have been unable to provide sufficient relief of the symptoms.

How neurolysis is performed

Neurolysis involves injecting a mixture of ethanol and anesthetic into the nerve to harden it. Injections may need to be administered once a week, for a month or two, to destroy the nerve and relieve symptoms.

Nerve surgery can be performed using either the plantar approach to remove the nerve tissue or the dorsal approach to relieve pressure on the nerve.

Plantar Approach

In the plantar approach, the nerve tissue is removed through incisions on the sole of the foot. This allows direct access to the neuroma. Crutches will be needed for at least three weeks following surgery to allow for proper healing, as weight should not be placed directly on the surgical site. In some cases, a scar may still form on the bottom of the foot which can make walking uncomfortable.

Dorsal Approach

In the dorsal approach, the metatarsal ligament is released through an incision on the top of the foot in order to reduce pressure on the nerve. Recovery is relatively quick since the incision is on top of the foot. However, with the metatarsal ligament released, the forefoot may gradually become unstable and require treatment in the future.