Neuroma/Nerve Decompression Surgery Treatment Fair Lawn, Riverdale and Englewood, NJ

Many people suffer from compression injury of nerves, the most common being a Morton’s neuroma. Conservative treatments often include use of metatarsal pads, orthotics, wider shoes, topical medications, oral pills, and various injections. Physical therapy including TENS and nerve gliding techniques may be helpful to reduce pain. If conservative care fails, we specialize in nerve decompression surgery. Instead of excising a painful nerve, which can lead to stump neuroma pain, we gently and meticulously free up the nerve from the surrounding offending structures. Sometimes, there is a small vein lying adjacent or crossing the nerve. This engorges with blood during exercise activity causing compression and pain. Sometimes, abnormal adhesions or scar tissue surrounding a nerve needs to be released. One’s genetic anatomy may predispose a nerve to be compressed between two metatarsal bones, held together by a tight ligament compressing the nerve. Hence, the ligament needs to be separated and cauterized. In other people, there may be a tight band of fascia or soft tissue covering which presses on a nerve, causing pain. This pain is exacerbated when the underlying muscles and vessels engorge with blood during prolonged walking or exercise activities. Surgical mini-incisions are often used to release the offending fascia or soft tissue resulting in pain reduction.

Micro Instrumentation

For nerve pain patients, I opt to release the abnormal pressures upon the nerve utilizing micro instrumentation. These procedures are performed under magnification to better visualize the nerve and surrounding structures. I often apply a viscous and regenerative substance, or a wrap around the nerve to augment healing and prevent reformation of adhesions and scar tissue. It is important to maintain mobility after the surgery to prevent formation of adhesions. This includes early limited ambulation.

Indication for Nerve Decompression Surgery

It should be known that nerve decompression surgery is appropriate for Morton’s neuroma pain between the metatarsals. It is also commonly used for posterior tibial nerve entrapment within the tarsal tunnel. In this condition, patients complain of burning and pain to the heel or arch and bottom of the foot. Nerve decompression is also helpful for those with pain to the top of the foot or across the ankle as a result of the superficial peroneal nerve and/or its branches being compressed by a shoe, boot, or brace. Some patients experience chronic calf pain during walking or standing secondary to impingement of the tibial nerve, with pain often radiating down the leg. In addition, compression of the saphenous nerve or superficial peroneal nerve may mimic shin splint pains along the inner or front shin. Finally, for those experiencing a recent drop foot or difficulty flexing their foot or big toe upward, nerve decompression is utilized to release the common fibular nerve of the leg often improving nerve conduction leading to increased muscle strength.

Dr. Braver is a fellow of the Association of Extremity Nerve Surgeons. He had to submit a variety of over 200 foot, ankle and leg nerve surgery cases. If you feel you can benefit from nerve care such as decompression surgery, with less risk than traditional excision surgery, please call our office for an evaluation.