Total Pageviews

Followers

Dr Blake's Book

Translate

Tuesday, February 4, 2014

Tuesday's Question of the Week: What % of Alcohol in the Shots for Morton's Neuromas

Dr. Blake,
Thanks, what do you think of the alcohol injections for Morton's Neuromas? Do they work?

Sam (name changed)

Dr. Blake (this sent one month later when I did not respond), 
I am looking to try the alcohol sclerosing for my MN. It will be a 0.25ml ultrasound guided injection with 4% alcohol. The podiatrist is looking to do 5-7 shots at 2 weeks apart. 

What is your take on the alcohol shots and are there any side effects or concerns?

Thanks again Sam

Dr Blake's response:

Sam, I typically try alcohol shots only after failure with the cortisone shots, orthotics, daily icing, etc. I like to get an MRI before doing the shots if possible. If the MRI shows a large neuroma, I only get 30% or less success with the alcohol shots. When you are considering the alcohol shots, you have to consider that you may need up to 3 sets of 5 shots. It is alot of shots. A back specialist should also be ruling out referred pain from the back, neck, or peripheral neuropathy. Rich

Dr. Blake,

Thanks for the information. I think my podiatrist in Arizona ordered the 4% solution and wants to start them and space out the shots every 2 weeks with a limit of 7 shots total. Is it necessary to wait 2 weeks between shots? You do them weekly with no adverse results. Why do some wait 2 weeks?

Does the higher alcohol content (6-8%) have better results?

Thanks,
Sam

Dr Blake's response: 

Sam, I mix my own, so typically now make 6% for the first series of 5 once per week. Based on the patient's feedback, I have been recently going with the second series of 5 (when needed) to 8%. Have not seen any problems (even post MRI imaging), but the shots are always irritative when given. Try to ice for 20 minutes post shot, and then another time that evening. And based on the article below from London, I am going to increase my percentage higher. But, not sure how much.  Rich


http://www.dailymail.co.uk/health/article-537748/The-shot-alcohol-cures-foot-pain.html

Dr. Blake,

The alcohol solution is on back-order here in Arizona (1-2 month wait). How do you make your own? It's basically diluted alcohol, right?

Thanks,
Sam

Dr Blake's response:

Use a 10 ml vial of 0.5% Sensorcaine (or equivalent) without epinephrine and withdraw 0.6 ml and discard. Take a 1 ml vial of denatured alcohol and draw up 0.6 ml. Inject this 0.6 ml back into the 0.5% Sensorcaine for your 6% alcohol soluation. Change amount based on % required. Rich

No comments:

Post a Comment

Thank you very much for leaving a comment. Due to my time restraints, some comments may not be answered.I will answer questions that I feel will help the community as a whole.. I can only answer medical questions in a general form. No specific answers can be given. Please consult a podiatrist, therapist, orthopedist, or sports medicine physician in your area for specific questions.