Injection Techniques for Common Chronic Pain Conditions of the Foot: A Comprehensive Review

Abstract

Purpose of Review: This is a comprehensive literature review of the available evidence and techniques of foot injections for chronic pain conditions. It briefly describes common foot chronic pain syndromes and then reviews available injection techniques for each of these syndromes, weighing the available evidence and comparing the available approaches. Recent Findings: Foot and ankle pain affects 20% of the population over 50 and significantly impairs mobility and ability to participate in activities of daily living (ADLs), as well as increases fall risk. It is commonly treated with costly surgery, at times with questionable efficacy. Injection therapy is challenging when the etiology is anatomical or compressive. Morton's neuroma is a budging of the interdigital nerve. Steroid, alcohol, and capsaicin injections Enhanced Digital Features To view enhanced digital features for this article go to https://doi.org/10.6084/ m9.figshare.11836971.

Platelet-Rich Plasma: New Performance Understandings and Therapeutic Considerations in 2020

“…Several studies have indicated little to no pain relief in patients treated for tendinosis pathologies or rotator cuff tears (143) (144). In contrast, several other studies indicated that PRP reduced or even eliminated pain in patients suffering from tendinosis, OA, plantar fasciitis, and other foot and ankle disorders (145) (146). The final platelet concentration and the biocellular composition have been identified as key PRP characteristics that contributed to the consistent analgesic effects observed after PRP applications.…”

High Volume Injection (Hydrodissection) for Tarsal Tunnel Syndrome Using Peripheral Nerve Stimulation: Treatment Protocol

“…The TN terminates by dividing into medial and lateral plantar nerves (MPN/LPN) (see Fig. 2) (Soneji & Peng, 2016;Urits et al, 2020).…”

“…TTS may have multiple causes such as thickening of the flexor retinaculum, bone compression or intra-tunnel pathologies (such as flexor tenosynovitis), cysts and other soft tissue masses, accessory muscles or vein-related pathology (Fantino et al, 2020). Diagnosis is based on the clinical history and physical examination findings, including a positive Tinel sign at the tarsal tunnel, which can be confirmed with magnetic resonance imaging (MRI) to identify space occupying lesions (SOLs) and nerve conduction studies (Urits et al, 2020). Ahmad et al (2012) and McSweeney and Cichero (2015) provide useful narrative overviews of the condition.…”

“…Ahmad et al (2012) suggest that corticosteroid injections may be sufficient to reverse any intraneural oedema. Urits et al (2020) postulate that injection therapy can provide a bridge to surgery but notes that no randomized controlled studies have been conducted, possibly because of the low incidence of the condition and the high frequency of surgical release.…”

Spezielle Schmerztherapie bei rheumatischen Erkrankungen

“…Das Thema der lokalen Schmerztherapie umfasst sicher mehr als hier im Rahmen dieses Artikels darstellbar. Es sei auf entsprechende Übersichtsarbeiten zu diesem Thema verwiesen [97][98][99][100][101].…”