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Recurrent Neuroma

The almost universal surgical approach for the treatment of Morton’s is to resect (cut out) the "neuroma" through an incision on the top of your foot. However, if the morton’s neuroma is excised, the chances are good that a true neuroma , stump or end bulb will develop

How does a TRUE Neuroma or Stump Neuroma or End Bulb Neuroma develop from a cut nerve as may occur after the removal of a Morton’s Neuroma?

When a nerve is cut, the piece of nerve that is beyond the cut point eventually dies, however, its Schwann cells, the cells that encircle the nerve fibers remain for a much longer time. These Schwann cells secrete a chemical messenger known as nerve growth factor that tells the cut end of nerve where to grow back. So the cut end of nerve will send out multiple sprouts in the direction of the nerve growth factor, however, these sprouts do not go out in an orderly manner, instead they grow out in all directions and eventually cluster and form a knot of nerve fibers. This eventually leads to the formation of a TRUE neuroma or a END BULB or STUMP neuroma. If it is in a place on your foot where you put a lot of pressure, it will become very painful.

To treat a painful, TRUE neuroma, the enlarged bulb and or sprouts are resected and implanted into the deep muscles forefoot or of the arch where the nerve feels more "at home". This takes the nerve out of a weight bearing region, into a quieter region where it will not be subject to weight or compression.