musculoskeletal and connective tissue disorders
Interdigital Neuroma
Treatment of Interdigital Neuroma
Modification of footwear and injection Neuroma of recent onset may resolve quickly with properly fitting shoes and insoles or with local anesthetic injection. Using a metatarsal pad placed proximally to the metatarsal heads of the affected interspace may also help reduce symptoms. Persistent symptoms may require one or more perineural infiltrations of long-acting corticosteroids with a local anesthetic. Injection is at a 45° angle to the foot, into the interspace at the level of the dorsal aspect of the metatarsophalangeal joints (see Considerations for Using Corticosteroid Injections ). Orthotics with neuroma pads, rest, cold packs, and properly fitting shoes often relieve symptoms. Nerve ablation techniques, such as injecting 20% alcohol with a local anesthetic directly into the nerve with ultrasonographic guidance, radiofrequency ablation ( If other treatments are ineffective, excision often brings complete relief. A true neuroma occasionally develops at the site of nerve excision (amputation or stump neuroma), which may require additional surgery. 1.Connors JC, Boike AM, Rao N, Kingsley JD: Radiofrequency ablation for the treatment of painful neuroma.JFoot Ankle Surg59(3):457-461, 2020. doi:10.1053/j.jfas.2019.09.003 