Morton's neuroma medical therapy
|
Morton's neuroma Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Morton's neuroma medical therapy On the Web |
|
American Roentgen Ray Society Images of Morton's neuroma medical therapy |
|
Risk calculators and risk factors for Morton's neuroma medical therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sara Mohsin, M.D.[2]Faizan Sheraz, M.D. [3]
Overview
Non-surgical treatment is instituted first.
Medical Therapy
- Non-surgical treatment is instituted first
- Physician may recommend any of the following:
Conservative therapy for Morton's neuroma
- Morton's neuroma should be managed conservatively before proceeding to expensive diagnostic procedures
- Conservative measures for pain relief include:[1][2][3][4][5][6]
- Decreasing pressure on the metatarsal heads by using:
- Metatarsal support
- Metatarsal bars
- Metatarsal pads
- Padded shoe insert (it's important to place inserts properly just proximal to the metatarsal head)
- Tapping the toe area
- Orthotics
- Specialized orthopedic shoes
- Shoes with wider toe boxes allowing spread of metatarsal heads
- Determine proper shoe width while standing with the help of a professional shoe fitting device
- Physical therapy
- Strength exercises for intrinsic foot muscles
- Decreasing pressure on the metatarsal heads by using:
Non-conservative medical therapy
- When conservative measures fail, following medical therapy is used for non-surgical treatment of neuroma:
- Tricyclic antidepressants
- Anticonvulsants (more effective)
- Serotonin-norepinephrine reuptake inhibitors
- Ultrasound-guided interdigital injection of following nerve blocking agents via dorsal approach into the site of tenderness:
- Steroid
- Local anaesthetic
- Anti-inflammatory drugs (orally or injected into the toe area)
- Painkillers (not recommended for long-term treatment)
References
- ↑ Kang JH, Chen MD, Chen SC, Hsi WL (2006). "Correlations between subjective treatment responses and plantar pressure parameters of metatarsal pad treatment in metatarsalgia patients: a prospective study". BMC Musculoskelet Disord. 7: 95. doi:10.1186/1471-2474-7-95. PMC 1712337. PMID 17147793.
- ↑ Jannink M, van Dijk H, Ijzerman M, Groothuis-Oudshoorn K, Groothoff J, Lankhurst G (2006). "Effectiveness of custom-made orthopaedic shoes in the reduction of foot pain and pressure in patients with degenerative disorders of the foot". Foot Ankle Int. 27 (11): 974–9. doi:10.1177/107110070602701119. PMID 17144963.
- ↑ Hsi WL, Kang JH, Lee XX (2005). "Optimum position of metatarsal pad in metatarsalgia for pressure relief". Am J Phys Med Rehabil. 84 (7): 514–20. PMID 15973088.
- ↑ Jackson L, Binning J, Potter J (2004). "Plantar pressures in rheumatoid arthritis using prefabricated metatarsal padding". J Am Podiatr Med Assoc. 94 (3): 239–45. PMID 15153584.
- ↑ Chang AH, Abu-Faraj ZU, Harris GF, Nery J, Shereff MJ (1994). "Multistep measurement of plantar pressure alterations using metatarsal pads". Foot Ankle Int. 15 (12): 654–60. doi:10.1177/107110079401501205. PMID 7894637.
- ↑ Holmes GB, Timmerman L (1990). "A quantitative assessment of the effect of metatarsal pads on plantar pressures". Foot Ankle. 11 (3): 141–5. PMID 2074081.