Advising Your Patients On Pain After Alcohol Sclerosing Injections For Morton`s Neuroma

A patient contacted me after experiencing pain in the left foot since September 2017. His podiatrist recently administered an alcohol sclerosing injection in the foot for Morton's neuroma.

Prior to receiving the shot, the patient experienced mild to moderate pain on the top of the foot and the ball of the foot. Since receiving the shot, he has experienced intense pain in the arch of his left foot. The podiatrist told him a sclerosing shot can cause an initial increase in pain. However, the patient wonders if it is normal that he would feel increased pain in a new area of the foot, namely the arch.

Unfortunately, I have had patients feel the entire bottom of the foot was hit by a board and they are very sore for up to two weeks after receiving an alcohol sclerosing injection. This pain is unusual and typically occurs after the first injection in the series, but the pain is definitely a temporary problem. The symptoms can last for four days to two weeks. All of my patients who had that experience did continue to have the complete series of five injections without other flare-ups. 

The patient says the pain he has been experiencing after the sclerosing shot is very intense and he is not sure he wants to proceed with the series of shots. He notes the original pain for the neuroma was “more tolerable and intermittent” while he says this new pain is “intolerable and constant.” The patient asks if he stops the alcohol sclerosing treatments, how long would it take for this new pain in the foot to subside?

The alcohol works on the nerves and nerve pain, of all the types of pain we deal with, is the most intense. Once this nerve pain calms down, it is still considered safe to continue with alcohol sclerosing injections and it is less likely that the patient will hurt as much. Alcohol sclerosing injections are safer overall than cortisone shots. That said, I do not know the volume or percentage of alcohol sclerosing injection this patient had.

When it comes to patients with nerve pain, one may consider basic treatments such as topical Neuro-Eze (Foot Express), neural flossing techniques, shoe selection, icing or other forms of anti-inflammatory measures, inserts with metatarsal padding and accommodative padding, etc.

Editor’s note: This blog originally appeared at https://www.drblakeshealingsole.com/2018/07/alcohol-shots-for-mortons-neuroma-email.html . It is reprinted with permission from the author.