Morton Neuroma
Conditions
Keywords
manipulation, plantar digital neuritis, morton's neuroma, nerve entrapment, foot
Brief summary
This study compares manipulative therapy to steroid injection in the treatment of Morton's Neuroma.
Detailed description
The aim of this study is to establish whether manipulative therapy is an effective treatment for Morton's neuroma, a nerve entrapment in the foot. Steroid injection is the current gold standard conservative treatment for this condition. Therefore, a subject group shall be compared to a steroid injection intervention group. Outcomes will be compared using visual analogue pain scales -VAS, Foot Function Index questionnaires and algometric pressure threshold testing. An improvement in the manipulation group VAS of 20mm above the injection group shall be considered as the minimum worthwhile change as this has been identified as the minimum clinically important difference in pain between treatment groups in visual analogue pain scales.
Interventions
DRUGmethylprednisolone
a single injection of 1 mL methylprednisolone \[40 mg\] and 1 mL 2% lignocaine
PROCEDUREmanual manipulation
The lesser MTPJs of the affected foot will be manually manipulated using a high velocity, low amplitude thrust technique.
Sponsors
Queen Margaret University
Dundee Podiatry Clinic
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* clinical diagnosis of morton's neuroma * over 18 years of age * presenting VAS score \> 30mm
Exclusion criteria
* diabetes, * rheumatoid arthritis * fibromyalgia. * Those currently taking Statins or analgesics * previous neuroma surgery
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Visual analogue pain scale | pre treatment at each clinic visit and then 3,6,9 and 12 months | Measuring changes in self reported pain over time. 100mm scale with anchored prompts of no pain at 0mm and worst pain ever at 100mm |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Algometric pressure threshold meter | pre treatment at each clinic visit and then 3,6,9 and 12 months | Measuring changes in pressure tolerance over time. A meter which reads how much change in pressure a joint can withstand before it registers discomfort |
Other
| Measure | Time frame | Description |
|---|---|---|
| Foot function index questionnaire | pre treatment at each clinic visit and then 3,6,9 and 12 months | A questionnaire to establish subjects level of function, pain and mobility changes over time |
| Manchester Oxford Foot Pain Questionnaire | pre treatment at each clinic visit and then 3,6,9 and 12 months | Patient reported outcome measurement tool to measure changes in foot pain over time |
| Short Form 36 pain and disability Questionnaire | pre treatment at each clinic visit and then 3,6,9 and 12 months | A quality of life questionnaire |
Countries
United Kingdom
Outcome results
None listed