Morton’s Neuroma Injection: Treatment Guide 2026 | DPM

Injection Type	Agent	Success Rate	Sessions	Mechanism
Corticosteroid	Triamcinolone 20–40mg + lidocaine	50–70% short-term (6–12 weeks); 30–40% at 1 year	Up to 3 injections; 6-week intervals	Reduces perineural inflammation and edema
Alcohol Sclerosing (4%)	4% ethanol solution (US-guided)	60–80% at series completion	4–7 injections; 2-week intervals	Destroys nerve sheath (neurodestructive); fibrous encapsulation
PRP (Platelet-Rich Plasma)	Autologous concentrated platelets	60–75% at 6 months (emerging evidence)	1–2 injections	Growth factors reduce inflammation; may promote nerve healing

Treatment	Indication	Success	Notes
Metatarsal pad + wide shoes	All patients — first-line	60–70%	Pad placed proximal to MT heads; spreads metatarsals; reduces nerve compression
Corticosteroid injection (US-guided)	Failed shoe modification 4–6 weeks	50–70% short-term	US-guided intermetatarsal dorsal approach; max 3 total
Alcohol sclerosing series	Failed steroid; recurrent neuroma; prefer non-surgical	60–80%	4–7 US-guided injections; 4% ethanol; effective long-term option
Neurectomy (dorsal approach)	Failed 6 months conservative + injections	80–85% long-term	Dorsal approach; 15–20 min in-office; 5–10% stump neuroma risk

Quick answer: Treatment for morton neuroma injection treatment guide follows a stepwise approach: 1) conservative care first (rest, ice, supportive footwear, OTC anti-inflammatories), 2) physical therapy and targeted exercises, 3) in-office treatments (injections, custom orthotics) if conservative fails at 4-6 weeks, 4) surgery for refractory cases. Most patients resolve at step 1 or 2. Call (810) 206-1402.

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Morton’s Neuroma: A Quick Overview

Morton’s neuroma is a painful thickening and degeneration of the interdigital nerve — most commonly between the third and fourth toes. The compressed nerve tissue causes burning, shooting pain, tingling, and a feeling like walking on a marble in the ball of the foot. Conservative treatment — including footwear modification, metatarsal pads, and injections — resolves symptoms in the majority of patients without surgery.

How Corticosteroid Injections Work

Corticosteroid (steroid) injections for Morton’s neuroma deliver a powerful anti-inflammatory medication directly into the intermetatarsal space around the neuroma. The steroid reduces perineural inflammation and fibrosis, decreasing the abnormal pressure on the nerve. Results are typically felt within 3–7 days and may last 3–12 months or longer. Ultrasound guidance allows precise placement of the medication at the neuroma, maximizing efficacy and minimizing systemic steroid exposure.

What to Expect During the Procedure

The injection is performed in the office and takes approximately 5 minutes. A small needle is inserted into the top of the foot (dorsal approach) or between the toes (plantar approach) into the affected interspace. A mixture of corticosteroid (typically triamcinolone or betamethasone) and local anesthetic is injected. Mild pressure discomfort is typical; significant pain is not. Patients walk immediately after the injection and may return to normal activity the same day.

Success Rates and Repeat Injections

Studies report 50–80% of patients experience significant pain relief after a single corticosteroid injection for Morton’s neuroma. If the first injection provides partial relief, a second injection 6–8 weeks later often provides additional benefit. Most protocols limit injections to 2–3 per neuroma due to theoretical risk of plantar fat pad atrophy and ligament weakening with repeated steroid exposure. Ultrasound guidance improves accuracy and reduces required injection frequency.

Alcohol Sclerosing Injections

Alcohol sclerosing injections (4% ethanol solution) are an alternative to corticosteroids, causing controlled chemical neurolysis of the neuroma. A series of 4–7 injections at 7–10 day intervals is required. Success rates of 60–89% have been reported in studies. Alcohol sclerotherapy is particularly valuable in patients where surgery is not preferred or who have already received multiple steroid injections.

When to Consider Surgery

Surgical excision of Morton’s neuroma is recommended when conservative treatment — including footwear modification, metatarsal pads, and 2–3 injection courses — fails to provide adequate relief. The neuroma is removed through a dorsal (top-of-foot) incision, with nerve resection proximal to the intermetatarsal ligament. Success rates are 75–85%. Permanent numbness between the affected toes is expected and typically well-tolerated. Dr. Biernacki discusses all treatment options before proceeding to surgery.

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In-Office Treatment at Balance Foot & Ankle

If home treatment isn’t providing relief for your morton neuroma injection treatment guide, our podiatry team at Balance Foot & Ankle can help with same-day evaluations and advanced in-office care.