Non-surgical treatments for Morton’s neuroma: A systematic review

Thomson, Lauren; Aujla, Randeep; Divall, Pip; Bhatia, Maneesh

doi:10.1016/j.fas.2019.09.009

Cited by 23 publications

(15 citation statements)

References 26 publications

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“…Corticosteroid injection is well accepted as a first-line treatment for Morton’s neuroma. 14,24,25 While the efficacy of corticosteroid injection for Morton’s neuroma is established in the literature, the longevity of its effect is less known, as most studies have only had short-term results. 10-13,19,20 To our knowledge, there are no prospective medium-term (3- to 5-year) studies on the effectiveness of corticosteroid injection in the management of Morton’s neuroma.…”

Section: Discussionmentioning

confidence: 99%

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Medium-Term Results of Corticosteroid Injections for Morton’s Neuroma

et al. 2020

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Background: The objective of this study was to evaluate the medium-term results of corticosteroid injections for Morton’s neuroma. Methods: This was a prospective follow-up study of a previous randomized controlled trial (RCT). Forty-five neuromas in 36 patients were injected with a single corticosteroid injection either with or without ultrasound guidance. As the results of the RCT showed no difference in outcomes between techniques, the data were pooled for the purpose of this study. Questionnaires were sent out and responses were collected via mail or telephone interview. Results were available in 42 out of 45 neuromas. There was a sex split of 68% female/32% male with a mean age of 62.6 years (SD, 12 years). Results: At mean follow-up of 4.8 years (SD, 0.91 years), the original corticosteroid injection remained effective in 36% ( n = 16) of the patients. In these cases, the visual analog scale (VAS) pain score ( P < .001) and Manchester-Oxford Foot Questionnaire Index (MOxFQ Index) ( P = .001) remained significantly better than preintervention scores. The remaining cases underwent either a further injection or surgery. Fifty-five percent of the 11 neuromas that received a second injection continued to be asymptomatic in the medium term. Overall, 44% ( n = 20) of the initial cohort underwent surgical excision by the medium-term follow-up. The VAS score, MOxFQ Index, and satisfaction scale score across all groups were not significantly different. Conclusion: Corticosteroid injections for Morton’s neuroma remained effective in over a third of cases for up to almost 5 years. A positive outcome at 1 year following a corticosteroid injection was reasonably predictive of a prolonged effect from the injection. Level of Evidence: Level II, prospective comparative study.

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Section: Discussionmentioning

confidence: 99%

“…10,12,13,20,21 The longer-term benefits of corticosteroid injections in treating this condition remain unclear in the literature. 14,21,24,25 To date, there is no literature on prospective medium-term outcomes. The main objective of this study was to evaluate the medium-term results of corticosteroid injections for Morton’s neuroma.…”

Section: Introductionmentioning

confidence: 99%

Medium-Term Results of Corticosteroid Injections for Morton’s Neuroma

et al. 2020

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“…Conservative treatment using plantar orthosis or US guided corticosteroid injection may be tried initially [94]. However, a recent systematic review found that about 50 % of patients relapse with pain after 1 year following corticosteroid injection and surgical treatment is eventually needed in 33 % of cases [95]. Surgical resection remans the definitive mode of treatment [85].…”

Section: Treatmentmentioning

confidence: 99%

Clinico-radiological review of peripheral entrapment neuropathies – Part 2 Lower limb

Manoharan

Sudhakaran

Goyal

et al. 2021

European Journal of Radiology

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This review discusses the relevant anatomy, etiopathogenesis, current notions in clinical and imaging features as well as management outline of lower limb entrapment neuropathies. Methods: The review is based on critical analysis of the current literature as well as our experience in dealing with entrapment neuropathies of the lower limb. Results: The complex anatomical network of nerves supplying the lower extremities are prone to entrapment by a heterogenous group of etiologies. This leads to diverse clinical manifestations making them difficult to diagnose with traditional methods such as clinical examination and electrodiagnostic studies. Moreover, some of these may mimic other common conditions such as disc pain or fibromyalgia leading to delay in diagnosis and increasing morbidity. Addition of imaging improves the diagnostic accuracy and also help in correct treatment of these entities. Magnetic resonance imaging is very useful for deeply situated nerves in pelvis and thigh while ultrasound is well validated for superficial entrapment neuropathies. Conclusion: The rapidly changing concepts in these conditions accompanied by the advances in imaging has made it essential for a clinical radiologist to be well-informed with the current best practices.

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“…Conservative (non-surgical) interventions for treatment of Morton's entrapment include orthoses and shoe gear modification, corticosteroid and alcohol injection, extracorporeal shockwave therapy, radiofrequency ablation, cryoablation, capsaicin injection, botulinum toxin, and laser therapy [20]. A systematic review for treatment of Morton's neuroma reveals conservative treatment can be effective.…”

Section: Conservative Treatment For Morton's Entrapmentmentioning

confidence: 99%

Considerations in the Diagnosis and Treatment of Morton’s Entrapment: A Review

2020

Integr J Orthop Traumatol

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Non-surgical treatments for Morton’s neuroma: A systematic review

Cited by 23 publications

References 26 publications

Medium-Term Results of Corticosteroid Injections for Morton’s Neuroma

Medium-Term Results of Corticosteroid Injections for Morton’s Neuroma

Clinico-radiological review of peripheral entrapment neuropathies – Part 2 Lower limb

Considerations in the Diagnosis and Treatment of Morton’s Entrapment: A Review

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