Steroid Injection Is Effective for Some Patients with Morton Neuroma

But the durability of the effect is unclear.

Morton neuroma is a painful fibrotic thickening of an interdigital nerve in the foot, usually between the third and fourth distal metatarsals. In this patient-blinded trial from Scotland, researchers randomized 131 patients (mean age, 53; 85% women) with Morton neuroma to receive injections — under ultrasound guidance — of methylprednisolone plus lidocaine or lidocaine alone.
On a global 100-point scale of foot health, methylprednisolone recipients had significantly higher scores at 1 month and 3 months than controls had. Mean scores (45 at baseline) changed minimally in the control group and increased by 14 points more in the steroid group than in the control group. On most secondary endpoints (by which pain, function, and health were assessed), outcomes were better in the steroid group; however, for some endpoints, significant differences at 1 month became statistically nonsignificant at 3 months. The proportion of patients who said their feet were "not better at all" was significantly higher among controls than among steroid recipients (52% vs. 32%).

CITATION(S):

Thomson CE et al. Methylprednisolone injections for the treatment of Morton neuroma: A patient-blinded randomized trial. J Bone Joint Surg Am 2013 May 1; 95:790.