Service evaluation outcomes of a Morton's neuroma injection service: A district hospital experience

Abstract

Purpose

To evaluate overall experience and relief from symptoms from our Morton's neuroma injection service.

Materials and methods

A telephone questionnaire was carried out between June 2011 and April 2012 on patients diagnosed with Morton's neuroma on ultrasound (US). This was to evaluate whether patients had gained benefits from the service in terms of symptomatic relief and also to gain a general understanding of whether the service had worked efficiently. A visual analogue score for pain, ranging from 1 (no pain) to 10 (Worst pain ever) was utilized to assess pre- and post-procedure responses. This specifically examined the time periods: before the injection, 1 week after, at follow up, and at the time when the questionnaire was asked. The patients' satisfactions with the service as well as any complications were ascertained. Patients with repeated episodes or bilateral injections were counted as one episode each.

Results

A total of 33 patients were identified (from a potential of 47, survey response rate of 70%) who had undergone injections for Morton's neuromas in the 10-month period, this included 9 males and 24 females. Injections were carried out under US guidance in real time, using an injection of Depo-Medrone injection (methylprednisolone acetate) 40 mg instilled into the neuroma. The mean pain score before the injection was 8.3 out of 10 (range 6−10). Mean score at time of follow up (or 2 months) was 4 (range 1–10). The majority of patients (19) required no medication after the procedure. There were 9 out of 33 recorded complications (27%), none of these were infection related. The mean overall experience score of the service was 7.9 out of 10 (range 4–10).

Conclusions

At our institution, we have been able to provide an intra-neural injection service with high satisfaction rates among patients. Injections have helped to alleviate symptoms among the majority, at least in the short-/mid-term although their long-term outcomes still appear quite variable.

Keywords:

• Foot pain
• Injections
• Musculoskeletal
• Morton's neuroma
• Pain scores
• Ultrasound guided