Morton's interdigital neuroma. Indications for treatment by local injections versus surgery

A retrospective study of 67 patients in whom Morton's neuroma had been diagnosed showed that 78% were women. The average age was 58 years (range, 19-85 years). Pain in the forefoot, which worsened with walking, was relieved by removal of shoes. The presence of local interdigital tenderness led to the diagnosis. Modification of shoes was helpful in two patients. The other 65 patients received a series of interdigital Xylocaine-steroid injections at one- to three-week intervals, which immediately relieved the pain in 30% of the patients and gave partial relief in 50%. At a two-year follow-up examination, 80% of the patients indicated complete relief of pain or had only slight pain. Surgical excision was indicated in those who failed to respond to the injections. Of 11 patients, surgical excision successfully relieved pain in four, effected partial relief in four, and failed in three. As a result of this retrospective study of patients with Morton's neuroma, the authors recommend therapeutic injections prior to surgery.