Corticosteroid Injection for Morton’s Interdigital Neuroma: A Systematic Review

Abstract

Category: Lesser Toes; Midfoot/Forefoot Introduction/Purpose: This review aimed to evaluate the effects of corticosteroid injections for Morton's neuroma using an algorithmic approach to assess the methodological quality of reported studies using a structured critical framework. Methods: Several electronic databases were searched for articles published until April 2020 that evaluated the outcomes of corticosteroid injections in patients diagnosed with Morton's neuroma. Data searches, extraction, analysis, and quality assessments were performed according to the PRISMA guideline, and the clinical outcomes were evaluated using various outcome measures. Results: With 3-12 months of follow-up, corticosteroid injections provided a satisfactory outcome according to Johnson satisfaction scores without two studies. Visual analogue scale scores showed maximal pain reduction between 1 week and 3 months post-injection. We found that 140 subjects out of 469 (29.85%) eventually underwent surgery after receiving corticosteroid injections due to persistent pain. Conclusion: Corticosteroid injections showed a satisfactory clinical outcome in patients with Morton's interdigital neuroma in spite of almost 30% of included subjects eventually underwent operative treatment. Our recommendation for the future study includes using more objective outcome parameters, such as foot and ankle outcome scores or foot and ankle ability measures. Moreover, studies about the safety and effectiveness of multiple injections at the same site are highly necessary.