Surgical decompression.
A focal surgical procedure to release the structures compressing a peripheral nerve. Offered when the non-surgical ladder has not resolved symptoms — not as a last resort from a different team.
What it is
For Morton’s neuroma, surgery typically means division of the transverse intermetatarsal ligament (decompression). Where decompression is insufficient or the nerve is irreversibly damaged, neurectomy (excision of the affected nerve segment) may be performed.
Minimally invasive approaches
Where anatomy and pathology permit, A/Prof Gilheany uses minimally invasive techniques that allow smaller incisions, faster recovery and reduced scar tissue.
When surgery is the right next step
- Persistent, functionally-limiting pain despite a full non-surgical ladder.
- Imaging-confirmed pathology unlikely to respond further to cryoneurolysis.
- Recurrent symptoms after prior surgery (revision decompression or resection of stump neuroma).
What to expect
- Pre-operative consultation, imaging review and surgical consent.
- Day-procedure in most cases at Masada Private Hospital or an affiliated facility.
- Protected weight-bearing in a post-op shoe for 2–3 weeks.
- Return to running typically 8–12 weeks post-op. Individual results vary.
Risks: As with any surgery — infection, bleeding, anaesthetic complications — plus the specific risks of this procedure: stump neuroma (reduced but not eliminated by careful technique), altered sensation, recurrence.
Who performs it: A/Prof Mark Gilheany — foot and ankle podiatric surgeon, pioneer of minimally invasive foot surgery in Australia.