Thursday, February 16, 2012

A Success Story!

About 2 weeks ago in my last blog posting, I talked about one of the treatment options for painful morton's neuromas - a cortisone injection.  Those who may remember, the "patient" was myself.  I had been having moderate pain in my right foot from the neuroma, and it was getting worse.  I decided to inject my foot with Kenalog, a type of cortisone.  The purpose of the injection was to help to relieve pain, and hopefully cause some shrinking of the neuroma itself. 

After my injection, I noticed an immediate decrease in pain.  This was expected, since I also had included a local anesthetic in the injection.  After several hours, the local anesthetic wore off, and the pain came back just as bad as before.  This was to be expected, and I was not surprised.  I can see how this can be discouraging to patients though, which is why I warn them that he effects of the cortisone can take a few days to become evident.  When I woke up the next morning, I was pleased to find that my pain level was decreased by about 50%.  The next day, the pain was 100% resolved!  That was a welcome relief!  Since that time, I have not had any pain in my foot whatsoever!

The real question now is this:  How long will this pain relief last?  The honest answer to that question is that I really don't know.  In most cases from patients I have injected for this condition through the years I have been in practice, pain relief will last for several months.  I do have some patients who never have symptoms again, others will come back 6 months later stating the pain has returned.  I have no problem with giving injections a couple times per year on an ongoing basis to control symptoms.  However, if the symptoms come back more quickly, it's time to get more aggressive.  I, like my patients, am hoping for the best!  Look for further updates on this subject in the coming months!


  1. Hi Doctor
    I just saw your post, in the two years since then, has the pain returned and what happened?

    1. Thankfully, the pain so far has not returned in my case.

  2. I just saw a reply in the previous post saying that the symptoms did not return! Congrats.

    I have to say, I really thank you for being a service to the community. The effort you are taking to reply to everyone's comments is very commendable.

  3. Hi

    I had 2 cortisone shots in my right foot for 2 different MNs about 72 hours ago. While I am not experiencing pain, I am having a tingling feeling when I put pressure on the foot. Is this normal since it has not been that long since I had the injections and will it go away soon?

    Thank you

    1. This is not typical following an injection. It is possible that the needle irritated the nerve. I would suspect that the tingling feelings you are having will gradually go away over the coming days. Let your doctor know if this is not the case.

    2. Thanks so much for the reply. I really do appreciate your time. I am battling a MN between my 3rd and 4th toe as well as one right under my big toe. That one causes the whole ball of my foot to burn.

      I was able to play hockey this morning but should I be totally pain free after the 2 cortisone injections? I am not in pain as much as I still can slightly feel some of the prior symptoms. Am I just being impatient? I really thought that I wouldn't feel anything after the injections.

      My main goal is to avoid surgery but I'm not holding out much hope. As soon as I can no longer skate I am doing it.

      One last question. Is it worth trying the alcohol injections first? I'm a major wimp when it comes to shots but a bigger wimp with scalpels.

      Sorry to be so long winded but these things are a major PITA.

      Thanks again

    3. Unfortunately, sometimes injections do not give the amount of relief from symptoms that is desired. You did say you had improvement, so that is good! Only you can decide if the amount of discomfort you're having following the injections is enough to warrant additional treatment.

      Regarding the alcohol injections, I have done them, and have had some success, although I have not found them to be as consistently effective as other treatment options, at least in my hands. For those who may not know, alcohol injections are done in a series of up to 7 injections into the nerve. The alcohol is supposed to destroy the nerve permanently, thereby eliminating pain. I have also found that insurance coverage for this procedure is not universal, so you'll want to check with your insurance company beforehand so you'll know who's paying for the procedure. Finally, these injections tend to burn a bit more than cortisone injections - certainly not something that's excruciating, but I feel it's always nice to know what you're getting into. Good luck!