This study compares manipulative therapy to steroid injection in the treatment of Morton's Neuroma.
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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
62
a single injection of 1 mL methylprednisolone \[40 mg\] and 1 mL 2% lignocaine
The lesser MTPJs of the affected foot will be manually manipulated using a high velocity, low amplitude thrust technique.
Podiatry Department NHS Lothian
Edinburgh, Lothian, United Kingdom
Visual analogue pain scale
Measuring changes in self reported pain over time. 100mm scale with anchored prompts of "no pain" at 0mm and "worst pain ever" at 100mm
Time frame: pre treatment at each clinic visit and then 3,6,9 and 12 months
Algometric pressure threshold meter
Measuring changes in pressure tolerance over time. A meter which reads how much change in pressure a joint can withstand before it registers discomfort
Time frame: pre treatment at each clinic visit and then 3,6,9 and 12 months
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