CLINICAL QUESTION

Are corticosteroid injections and surgical interventions effective in treating Morton neuroma?

EVIDENCE-BASED ANSWER

In patients with Morton neuroma, combined corticosteroid/local anesthetic injection does not improve pain, function, or quality of life at 3 to 6 months vs. local anesthetic injection alone. More adverse events, including skin and plantar fat pad atrophy and hypopigmentation, occur with the addition of a corticosteroid. (Strength of Recommendation [SOR]: B, inconsistent or limited-quality patient-oriented evidence.)

Compared with non–ultrasound-guided corticosteroid/local anesthetic injection, ultrasound-guided injection probably improves pain, function, and patient satisfaction at 6 months with little to no difference in adverse events. (SOR: B, inconsistent or limited-quality patient-oriented evidence.)

There appears to be little to no difference in patient satisfaction or rates of adverse events between plantar incision neurectomy and dorsal incision neurectomy.¹ (SOR: B, inconsistent or limited-quality patient-oriented evidence.)

PRACTICE POINTERS