Procedure
Morton's Neuroma Injection
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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]
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