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Thursday, July 19, 2018

Alcohol Shots for Morton's Neuroma: Email Advice

Dear Dr. Blake,

I found your blog several days ago and have found it very helpful and informative. I have been experiencing pain in my left foot since September 2017. This past Wednesday my podiatrist administered an alcohol sclerosing injection in my foot for a Morton's Neuroma. I have a follow-up appointment with my podiatrist next week; in the meantime, I have two main questions about the shot that I was hoping that you could answer.

1. Prior to receiving the shot on Wednesday, I experienced mild to moderate pain on the top of my foot and the ball of my foot. Since receiving the shot, I have experienced intense pain in the arch of my left foot. My podiatrist told me that a sclerosing shot can cause an initial increase in pain; however, is it normal/to be expected that I would feel increased pain in a new area of my foot (the arch?)
Dr. Blake's comment: Yes, unfortunately, I have had patients feel the entire bottom of the foot was hit by a board, and very sore for up to 2 weeks. Unusual, and typically the first one in the series, but definitely a temporary problem. The symptoms can last for 4 days to 2 weeks. All of my patients that had that experience did continue to have the complete series of 5 without other flare-ups. 

2. The pain that I have been experiencing after the sclerosing shot is very intense, and I am not sure that I want to proceed with the series of shots. The original pain from my neuroma was more tolerable, and was also intermittent--this new pain is intolerable and constant. If I were to stop the sclerosing treatments, how long would it take for this new pain in my foot to subside? Also, are there different courses of treatment that I could discuss with my podiatrist?
Dr. Blake's comment: I can sympathize with you. The alcohol works on the nerves and nerve pain, of all the types of pain we deal with, is the most intense. Once this calms down, it is still considered safe to continue, and less likely you will hurt as much. Alcohol is safer overall then cortisone shots. What I do not know is how much volume or what percentage was used, or even if the right technique was utilized to advise you further? I can comment more if you get me at least the information on percentage. 
     When you treat nerve pain, you should be doing the basic treatments of Neuro-Eze topical, neural flossing techniques, shoe selection (what feels better less padding or more, stiff or flexible, rocker or not, etc), icing or other forms of anti-inflammatory measures,  inserts with metatarsal padding and accommodative padding, etc. Let me know what else you are doing. Also, let me know how long it takes to feel better. Good luck. 

I hope these questions are clear. Thank you for writing such a thorough and helpful blog. 

Sincerely,

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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.