A treatment protocol offered by Dr. Tompkins
Sclerosing Injection Treatments
for Mortons Neuroma
since January of 2004
Sclerotherapy is a procedure which involves the injection of a sclerosing agent (causes scarring) into a particular area/site of the body. Sclerosing injections have been used for many years in the treatment of varicose veins, and also in the throat and liver.
The adaptation of using a sclerosing agent in the treatment of MN was introduced by Dr. Dockery in 1999. The treatment involves a series of injections into the area proximal (in front of) the area of the actual nerve tumor itself.
Sclerosing treatments for MN involve the use of a mixture of a local anesthetic called marcaine, and anhydrous alcohol. These two ingredients are combined to create a 4% alcohol solution. .5 cc’s (one-half of a cc) is injected into the nerve a few centimers proximal to the tumor. The 4% alcohol solution creates sclerosis (scarring) within the nerve tissue which chemically inactivates the nerve. This prevents the transmission of the pain sensations that are associated with MN.
There are a number of different protocols used in sclerosing treatments for MN. The protocol I currently utilize is a series of 5 bi-weekly injections. At the end of the 5thtreatment, if the patient has had any noticeable improvement, anywhere from 7 to 10 (total) bi-weekly injections are given, depending on individual patient response.
If there has been no improvement or response after 5 sclerosing treatments, I do not recommend any additional injections. These patients can either live with the pain/disability of the MN, or can contemplate surgical excision.
The injections are given with an extremely small bore (27 gauge) needle into an area on the top of the patient’s foot. Most patients find the injections are only minimally painful, with little to no side-effects. Occasionally (25% of injections) there can be a bit of bruising and/or some discomfort the next day or two. I typically put a special pad on the bottom of the foot after each treatment and ask the patient to do only normal walking for the next 48 hours.
Since incorporating Sclerotherapy into my treatment regimen for moderate to severe cases of MN (Jan of 2004), I have been able to significantly reduce the number of surgical excisions necessary in my patient population, with very limited side-effects or complications.
Sclerotherapy is not for every patient with MN, nor will every patient respond to this type of treatment. However, with the choice of either living with the pain and disability of MN, or electing to undergo surgical excision, I find this type of treatment to be an excellent alternative.
If you feel you might have this very treatable podiatric problem, it is imperative that you seek professional treatment as soon as possible to ensure a successful outcome.