A Morton’s Neuroma is an enlargement or thickening of a nerve in the foot, usually between the third and fourth or second and third toes. It is often caused by irritation or compression of the nerve which leads to swelling and pain.
Certain shoes can cause compression of the nerve, making this worse. This can be diagnosed by a variety of different techniques, but we will usually examine the forefoot and ask about your clinical history. When required we support a diagnoses with an ultrasound or MRI scan.
An alcohol injection can reduce the pain
Injecting alcohol into the neuroma will aim to slowly breakdown the nerve, reducing the pain and decreasing its size. Many studies have reported high success rates with the best research showing 89% success (Dockery, 1999).
Alternatives lack good evidence
There are several treatments for neuroma, but the research is often of poor quality or confusing results:
- Changing shoes and avoiding heeled or tight shoes you can help reduce the swelling an pain.
- Specialist insoles or pads can be used to reduce the load on the area and reduce the irritation.
- Steroid injections can reduce the neuroma pain, but it usually only lasts between 3 and 12 months. A series of 3 injections 8 weeks apart has some anecdotal evidence of working, however steroid injections can have other issues such as limited effectiveness, local skin reactions, and loss of fatty padding.
- Cryotherapy can be used to freeze the nerve to kill it but there is very little evidence supporting this as a treatment.
- Acupuncture can help in pain management.
- Botulinum Toxin A injections is a very new technique and the effectiveness is still being assessed.
- Surgery can be used to completely remove the nerve or reduce the compression on the nerve. This can be from the top or bottom of the foot and the success rates reported are about 90%.
We inject just behind the tenderness
It consists of a 4% alcohol solution with a long-acting anaesthetic which also contains adrenaline. This is used to give pain relief and keep the solution in the area. It is placed just behind the point of maximum tenderness for the greatest effect, and some pain or tingling will often be experienced when the nerve is reached. The injections are done in a clean treatment room.
There are risks, but they are negligible
An alcohol injection is a common treatment, but there is a very small risk of infection which we try extremely hard to prevent. In some very rare cases, a red line can appear on the foot or leg. You may also react to the adrenaline, especially if you have a reaction at the dentist.
Some discomfort is expected
Over the first few days it is possible your foot may feel uncomfortable. The first two injections can cause a small increase in pain. We recommend taking normal pain relief tablets to help with this. It is important that you monitor and keep a record of any changes in your pain over the next few weeks as this information may be useful to us.
You will need to rest after each injection
It is important that you do not drive or operate machinery for 6-8 hours after each injection, and you will need somebody to drive you home from after the treatment.
You must attend all 5 weekly appointments
The treatment involves a series of 5 injections with 1 week between them. It is important that you do not miss any one of the appointments in the series or the treatment must be restarted.
We are the only practice in the area to offer this treatment
Thanks to our highly qualified staff and their skill we are proud to be the only qualified and registered practice in Staffordshire to offer alcohol injections for Morton’s Neuroma.