Neuromas usually present as forefoot pain that is common in woman between the ages of 40-60. Most patients describe a burning or tingling that is worse in shoes. This is most common between the 3rd and 4th toes but can also be present between the 2nd and 3rd. This is primarily do to the anatomical design of the foot and the coming together of nerves in that location.

There are many different treatment options for neuromas and to date one is the most successful. Treatments options can range from toe spacers to injections and physical therapy. The most successful seem to be injection therapies and offloading of the nerve. A well-made prescription orthotic can be extremely helpful for active patients.

Injection therapy is the mainstay of neuroma treatments. Currently the most successful by far is alcohol injections. Alcohol injections work via osmosis by dehydrating the nerve. Our nerves are primarily composed of water and if alcohol is injected adjacent to the nerve over time the nerve will shrink. The nerves that are involved with neuroma formation are sensory nerves. This means these nerves provide pain input and do not contribute to any movement of the toes. The most promising part of alcohol injections is the success rate. The literate states these injections are 89% successful. This is a great option for anybody not wanting surgery.

I have been utilizing alcohol injection therapy for more than 10 years. I can tell you it is highly successful but user dependent. What I mean by that is you need to have a physician that is doing a lot of these to get the best result. I also advise do not have a physician inject without the use of an ultrasound. An ultrasound is key to the successful outcome. Ultrasound helps to identify the nerve and then one can watch the needle placement and the injection will be highly successful. Again I cannot stress that enough, find a physician with an ultrasound so you have the best possible outcome!

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