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Morton's Neuroma Injection
Aka: Morton's Neuroma Injection, Interdigital Neuroma Injection
- See Also
- Joint Injection
- Injectable Corticosteroid
- Indications
- Morton's Neuroma refractory to other measures
- Preparation
- Needle
- Gauge: 25 to 27
- Length: 1.0 to 1.5 inches
- Syringe: 3 to 5 ml
- Corticosteroid options
- Betamethasone (Celestone) 0.5 ml of 6 mg/ml
- Methylprednisolone (Solu-medrol): 0.5 ml of 40 mg/ml
- Anesthetic
- Lidocaine 1%: 1 to 2 ml or
- Bupivacaine 0.25% or 0.5%: 1 to 2 ml
- Technique
- Patient position
- Supine position with knee flexed over towel roll
- Foot in neutral position
- Landmarks
- Interdigital space between Metatarsal heads
- Mark area maximal tenderness
- Sterilize local skin with betadine or hibiclens
- Insert needle into skin at point of maximal tenderness
- Angle needle 45 degrees proximally toward heel
- Do not inject into plantar fat pad
- Patient lies supine for several minutes after procedure
- Distribute with passive foot range of motion
- Adverse Effects
- Plantar fat pad atrophy
- Follow-up Instructions
- No stress to foot for 2 weeks after injection
- Examine again in 3 weeks post-injection
- References
- Greene (2001) Musculoskeletal Care, AAOS, p. 480-1
- Tallia (2003) Am Fam Physician 68(7):1356-62 [PubMed]