Effects of 4% Ethanol Sclerosing Injection on Morton's Neuroma: A histological study

J Am Podiatr Med Assoc. 2020 Jul 15. doi: 10.7547/17-094. Online ahead of print.


Background: Non-operational treatments for Morton's neuroma remain controversial because it was believed sclerosing injections do not change nerve fibers on a cellular level. Up to 80% success rates with 4% ethanol sclerosing have been documented while the remainder require operational removal of the painful nerve. We sought to evaluate the histological characteristics of Morton's neuromas treated with either 4% ethanol sclerosing injection versus steroid injection alone from patients who required removal of the nerve for pain relief.

Methods: A retrospective histologic review was performed on 24 consecutive patients who were treated with either sclerosing injection versus non-sclerosing injection and underwent nerve removal between 2012 to 2015.

Results: 19 patients met inclusion criteria, of which 8 patients received sclerosing injections and 11 patients received non-sclerosing injections. Intraneural fibrosis was seen higher in the non-sclerosing injection group (p = 0.008).

Conclusions: Histological changes are seen in Morton's neuroma with the use of 4% ethanol sclerosing injection contrary to prior studies.

Keywords: Histological; Injection; Morton's Neuroma; Sclerosing.