I’m going to have a steroid injection into my very large Morton’s neuroma. Do you think a big one like mine is less likely to get better with just one injection? Will I end up having to go back for more?

The question of whether size matters when treating Morton’s neuroma) by steroid injection has been raised by a group of researchers from Scotland. Usually, this type of treatment involves an injection of lidocaine and cortisone into the area. There is some evidence that this approach may help temporarily relieve symptoms. But this is usually short-lived (days to weeks) and is mainly useful to help the doctor make a diagnosis.

The study performed at The Royal Infirmary of Edinburgh in Scotland was done to test out whether a corticosteroid injection is more effective than an anesthetic injection. In the process, they used ultrasound imaging to guide the needles and were thus able to measure the size of the neuromas and study the influence of size on the results.

Half of the 131 patients (85 per cent women, 15 per cent men) were given a single injection of methylprednisone (a corticosteroid antiinflammatory) combined with an anesthetic (numbing agent) directly into the neuroma. The other half received the same treatment but with just the anesthetic (lignocaine).

Results based on pain, function, and patient opinion of their own general health were measured one- and three-months later. Patient-surveys were used to gather information on pain, work and activity levels, walking, sense of well-being, emotional pain, rating of general health, and quality of life.

They found a significant difference (greater improvement in the corticosteroid group) one month and three months after treatment. It turns out that size did NOT make a difference. Patients with small to large neuromas received the same amount of relief and improvement with the corticosteroid injections. For the most part, results favored the use of corticosteroid injection. Complete pain relief was not reported in either group. Longer follow-up will be conducted to see if the benefits continue into the long-term as well.