Welcome to the Podiatry Arena forums

You are currently viewing our podiatry forum as a guest which gives you limited access to view all podiatry discussions and access our other features. By joining our free global community of Podiatrists and other interested foot health care professionals you will have access to post podiatry topics (answer and ask questions), communicate privately with other members, upload content, view attachments, receive a weekly email update of new discussions, access other special features. Registered users do not get displayed the advertisements in posted messages. Registration is fast, simple and absolutely free so please, join our global Podiatry community today!

  1. Everything that you are ever going to want to know about running shoes: Running Shoes Boot Camp Online, for taking it to the next level? See here for more.
    Dismiss Notice
  2. Have you considered the Critical Thinking and Skeptical Boot Camp, for taking it to the next level? See here for more.
    Dismiss Notice
  3. Have you considered the Clinical Biomechanics Boot Camp Online, for taking it to the next level? See here for more.
    Dismiss Notice
Dismiss Notice
Have you considered the Clinical Biomechanics Boot Camp Online, for taking it to the next level? See here for more.
Dismiss Notice
Have you liked us on Facebook to get our updates? Please do. Click here for our Facebook page.
Dismiss Notice
Do you get the weekly newsletter that Podiatry Arena sends out to update everybody? If not, click here to organise this.

Alcohol for Neuroma Injection

Discussion in 'General Issues and Discussion Forum' started by Mathew Vaughan, Jun 20, 2013.


  1. Members do not see these Ads. Sign Up.
    Hi,

    I am looking to offer my patients that do not respond to steroid and biomechanical intervention alcohol injections for their neuromas. I can find lots of papers on the subject but I am not 100% sure what form of alcohol to order from my pharmacist to actually inject.

    If anybody can let me know exactly what i request from my pharmacist I would greatly appreciate it.

    Mathew
     
  2. Ella Hurrell

    Ella Hurrell Active Member

    Hi stranger :)
    I don't know personally but I know Ian Reilly was doing these a while back. Think he's on here-maybe drop him a line
    Hope you're ok x
     
  3. AngieR

    AngieR Active Member

    Matthew,

    Long time no see (Edinburgh Pub with Kevin)

    My concern here is insurance, have you been trained to use alcohol injections? I use glucose prolotherapy and have a really good success rate.
    Do some research on the net!

    Do I need to book in to come and do it? Not been to Cardiff yet - ;)

    Angie
     
  4. Stanley

    Stanley Well-Known Member

    Hi Matthew,

    I have been using alcohol injections for years with good success.

    First of all the mixture is a 4% ethyl alcohol/96% local anaesthetic. (You can remove 2cc from a 50cc vial of local anaesthetic and replace it with 2 cc of absolute ethyl alcohol)

    Secondly, this does not kill the nerves, but rather stimulates it to heal. So do not mix corticosteriods with this injection. However, if there is adhesions/scar tissue around the nerve corticosteroid injections should be done first until this is resolved and then follow up at a seperate visit with the alcohol injections.

    The location of the injection is determined by finding a positive Tinel's sign.

    I deposit 1cc/linear inch of nerve damage.

    If this is due to a traumatic incident, 1 injection usually suffices. If it is due to a biomechanical issue, then the biomechanical issue needs to be addressed.

    In the case of a Morton's neuroma, the 4th metatarsal cuboid joint needs to be addressed. Follow this with an orthosis that supports this area (with a metatarsal pad and something under the 5th metatarsal head), and balance out the shortage if it exists on that side.

    In the last 15 years, the only Morton's neuromas I had to remove were those that were previously treated by another podiatrist.

    I hope this helps.

    Regards,

    Stanley
     
  5. drdebrule

    drdebrule Active Member

    Agree with Stanley above. However, I prefer 8% alcohol mix with ultrasound guidance- just add 4cc instead if you want to try this. I started using the 8% before the 4% caught on. I usually perform injections two weeks apart up to four injections.

    I am still waiting for a placebo controlled study to come out on this treatment option. If anyone knows of one or wants to do one that would be great.
     
  6. Ian Reilly

    Ian Reilly Active Member

    Hi Matt

    absolute alcohol, when i get a mo i will dig out the box. Been doing them for 15 years but never got Dock Dockery's results. There's a real knack to it.

    Dock say to inject the normal nerve proximal to the swelling. Have gone off them due to the increased number of shots required, but am interested in the outcomes for prolotherapy too. I hear good things about it from colleagues.

    In an ideal world i would just be doing the surgery and not doing any injections myself! LOL

    AB

    Ian
     
Loading...

Share This Page