Morton's Neuroma: Manipulation Versus Steroid Injection
Neuroma, Human Forefoot
About this trial
This is an interventional treatment trial for Neuroma, Human Forefoot
Eligibility Criteria
Inclusion Criteria:
- Inclusion criteria shall be any positive clinical sign together with a positive diagnostic ultrasound giving rise to a diagnosis of Morton's neuroma/plantar digital neuritis.
- A VAS score of no less than 25/100 will also be required.
- All subjects must be over 18 years of age and able to offer informed consent.
Exclusion Criteria:
- Absolute exclusion criteria will include Rheumatoid Arthritis, recent (less than 3 months) fracture to the affected foot, peripheral neuropathy, localised infection, pregnancy, allergy to Methylprednisolone.
- Allergy to local anaesthetic.
- Further exclusion criteria include Active infection
- Diabetes mellitus
- Ulcerative colitis
- Diverticulitis
- Hypothyroidism
- Osteoporosis
- Renal impairment
- Hepatic impairment and Coagulation disorders.
Sites / Locations
- Queen Margaret UniversityRecruiting
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
manipulation
Steroid
Those in the manipulation group shall have the lesser MTPJs of the affected foot manually manipulated using a high velocity, low amplitude thrust technique. They will be asked to return once each week for a further five weeks. At each visit the VAS and PTM measurements shall be repeated, as will the manual manipulation. They shall also be asked to return for a review in the sixth week.
Those randomised to the steroid group shall receive a single injection of 1 mL methylprednisolone [40 mg] and 1 mL 2% lignocaine. They shall then be asked to return for review in six weeks. A second injection may be offered at this point if clinically indicated.