Steroid injections for Morton’s neuroma offer a targeted approach to relieving the pain of plantar digital neuritis, commonly known as Morton’s neuroma. This condition is characterized by intense burning pain or abnormal sensations in the space between the metatarsal heads, most often between the third and fourth metatarsal bones.
The condition typically involves a painful swelling of the common digital nerve just below the deep transverse metatarsal ligament. It occurs most often between the third and fourth metatarsals, either between or just beyond the metatarsal heads. Patients often report a history of burning pain, especially at night, along with a sensation of pressure or excessive nerve strain caused by overextending the toes. These symptoms are classic indicators of this specific condition.
Injecting an interdigital neuroma is generally effective for symptom relief. However, if the patient continues to wear thin-soled, excessively high-heeled, or otherwise unsuitable footwear, symptoms may recur.
To reduce compression after the injection, it is helpful to use a small pad near the metatarsal head to elevate the bone during the first few weeks. If symptoms return, the patient should consult a foot surgeon to explore surgical options.
When administering injections near nerve tissue, proceed with caution to avoid sudden, severe pain that might startle the patient if the needle contacts the nerve. It is essential to apply the medication around the neuroma, not directly into the nerve itself, as this could cause lasting damage.
Ultrasound can be used to guide Morton’s neuroma injections, enabling more accurate therapeutic intervention with good short-term clinical results.
In one study, sonography clearly identified neuromas as incompressible, hypoechoic nodules that replace the normally hypoechoic webspace fat. Neuromas could be distinguished from other causes of forefoot pain, such as synovitis of the metatarsophalangeal joint and intermetatarsal bursae. The size of the injected neuromas ranged from 4 to 19 mm.
After the Morton’s neuroma injection, all neuromas showed increased echogenicity and/or the appearance of surrounding fluid, confirming the location of the therapeutic mixture.
