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Alcohol sclerosing injections anyone?

Posted by Shell D. on 4/06/05 at 13:37 (172716)

Could anyone give me some information on alcohol sclerosing injections. I will be receiving these injections in the next few weeks for my neuromas and was wondering how effective they are and how painful they are. I've had many cortisone injections. Are they similar to those or MORE painful?

Re: Alcohol sclerosing injections anyone?

Ralph on 4/06/05 at 15:46 (172722)

Shell,
There have been some posts about this treatment by others. I found a few when I used the 'search' tab on this website. If you don't get any personal responses try the search feature or try it anyway. It's very good.

Re: Alcohol sclerosing injections anyone?

Dr. Z on 4/06/05 at 22:33 (172738)

I have used them for years with good results. They can help you avoid foot surgery. When I give them they are not that painful. Some patients on this board report alot of pain with these injections.

Re: Alcohol sclerosing injections anyone?

John H on 4/07/05 at 09:42 (172748)

What do these do Dr Z? If one has a chronically inflamed fascia for some years would this help? Multiple shots from the bottom????

Re: Alcohol sclerosing injections anyone?

Ralph on 4/07/05 at 11:44 (172757)

John,
I read those shots actually kill the nerve.

Re: Alcohol sclerosing injections anyone?

Dr. Zuckerman on 4/07/05 at 13:23 (172769)

No. But if you have a sensory nerve problem ie Baxters yes they could. I believe you might have both John H, so it could be worth your time to investigate this treatment
What the treatment does is eliminate some of the covering of the sensory nerve that transmits pain. The covering will grow back but hopefully without a pain memory

Re: Alcohol sclerosing injections anyone?

Dr. Zuckerman on 4/07/05 at 13:24 (172770)

Just the covering of the nerve NOT the entire nerve

Re: Alcohol sclerosing injections anyone?

elliott on 4/07/05 at 14:06 (172775)

The link below, by Dr. Fallut of cryosurgery fame in an article supporting cryo over alcohol, makes it sound like it destroys everything in sight. Furthermore, he gives several negatives about these shots, although some of them are speculative and others (e.g., no long-term followup) really appply to cryo as well.

http://www.podiatrytoday.com/podtd/displayArticleaa.cfm?articleID=article2691

I don't really care too much about temporary pain if it will permanently cure a problem.

When you listen to some, it seems like alcohol sclerosing injections should make traditional surgery go the way of the dinosaur. If this is accurate, then everyone should come over to it. If not, it should be made clear why not.

Re: Alcohol sclerosing injections anyone?

Dr. Zuckerman on 4/07/05 at 14:21 (172777)

I have used alcohol shots for years. They work in the cases where there isn't this large neuroma mass. You must combine other treatments and not just get shots. I find the metatarsal padding that lifts the bones away from the nerve is just about the easiest, quickest fix around. Checking out the patients shoe gear is a first must.
I really haven't had any serious problems with Alcohol but then again I just don't use the alcohol and I use the orginal formula which might need more treatment but in my opinion is less painful.
Steriod injections can and do cause problems such as toe dislocations, displaced metatarsal bone. Local steriod injection can weaken ligament. I have repaired three toe dislocation in the last six months from local steriod injections. I have never seen this problem with alcohol injections.
My surgical excisions for neuroma has been reduced since these injections have entered the treatment scene

Re: Alcohol sclerosing injections anyone?

elliott on 4/08/05 at 08:36 (172821)

Dr. Z, would the metatarsal padding likely lead to a cure, i.e., disappearance of the neuroma and being painfree all the time, or would it tend to provide relief only while the foot is resting on the pad?

Re: Alcohol sclerosing injections anyone?

Dr. Z on 4/08/05 at 20:55 (172864)

In the early stages it will lead to a cure. With a true neuroma no . Most of the time we are dealing with a neuritis and not a neuroma. A change in shoe gear, wider shoes will also lead to a cure in the initial early stage. Early is probaby weeks to a few months.

Re: Alcohol sclerosing injections anyone?

Amy on 4/09/05 at 20:35 (172905)

So this could help with a baxters nerve entrapment? Just trying to keep my options open...

Re: Alcohol sclerosing injections anyone?

Liboralis on 4/10/05 at 21:03 (172936)

What is the possibility that many neuromas are really metatarsalgia or synovitis? and how and what is the difference and how do you tell?

Re: Alcohol sclerosing injections anyone?

Ed Davis, DPM on 4/12/05 at 18:00 (173082)

Liboralis:
Sometimes neuromas are large enough to be 'popped' by squeezing the metatarsal heads together from side to side while placing pressure on the suspect area (AKA Mulder's sign). Another good way is with sonography (diagnostic ultrasound). One thing I like about the latter is that we can get the exact dimensions of the neuroma. I find that to be useful in predicting the outcome of treatments. For example, if the neuroma is too big, then alcohol or cortisone shots are less likely to work and surgery may be a better answer.
Ed

Re: Alcohol sclerosing injections anyone?

Ed Davis, DPM on 4/12/05 at 18:07 (173083)

Elliott:
The alcohol technique uses 4 % alcohol. That percentage destroys the type C umyelinated (uninsulated) nerve fibers, leaving the better protected fibers alone. Think of a nerve as a coax cable with lots of differrent wires. Only when using higher concentrations of alcohol does one have to be concerned about destroying other types of fibers.

The shots are not the most comfortable thing in the world and the area gets sore once the anesthetic wear off, sometimes for a day. I prefer to use sonography to know the exact size of the neuroma as I feel it improves predictablity of the efficacy of the shots. I feel the shots don't work as well in larger neuromas.
Ed

Re: Alcohol sclerosing injections anyone?

Dr. Z on 4/12/05 at 18:16 (173084)

Ed,
You make an excellent point about the size and the success with alcohol sclerosing injections

Re: Alcohol sclerosing injections anyone?

dan on 4/19/05 at 19:55 (173428)

I had one today. Just a bee sting. Walk in the park/

Re: Alcohol sclerosing injections anyone?

cindyh on 10/25/05 at 13:32 (185704)

I had my first injection for a neuroma in my right foot last night. It feels like I have a lump under the ball of my foot right now. Not that bad - just odd.

I don't know what I am in for, but I hope it is a relief from the constant burning/pain from the neuroma that I have been dealing with for some time.

The injection was not fun, the doctor mentioned that I could possibly have a large neuroma... don't know if that makes a difference or not.

Re: Alcohol sclerosing injections anyone?

Marjorie P. on 10/28/05 at 14:08 (186037)

I find it interesting that doctors usually say somehting is not painful, when they themselves have not actually undergone the procedure. I am currently trying these injections after having tried cortisone injections, metatarsal pads, custom orthotics and physical therapy. I find the injections painful, but just as I reach the point where I don't think I can tolerate it anymore, it's over. I make the doctor talk to me about anything he wants to help distract me. I also squeze a rubber ball. Afterwards the injection drives me to distraction with itching for about 2 days. Only had 4 injections so far and haven't noticed a difference. Doctor says it can take up to 6 to notice a difference. Curious as to how others are tolerating these injections.

Re: Alcohol sclerosing injections anyone?

cindyh on 10/29/05 at 07:46 (186093)

I am going for my 2nd injection on Monday. After the first one I noticed the burning sensation (similar to what I have been dealing with for some time). Not much difference yet. I guess the down side is that for the 2nd injection I know what to expect (and I am not looking forward to it!).

I'll keep you posted!

Re: Alcohol sclerosing injections anyone?

cindyh on 11/01/05 at 05:12 (186364)

So far - so good. The second shot wasn't as bad as the first.

Re: Alcohol sclerosing injections anyone?

cindyh on 11/16/05 at 08:14 (187560)

4th injection --- the ball of my foot is more sore than usual under the injection area.

Re: Alcohol sclerosing injections anyone?

cindyh on 11/25/05 at 17:37 (188190)

I am on my 5th injection. There is quite a lump (I think it is the alchohol that isn't being absorbed) forming underneath on the ball of my foot. I think it is time to take a break from the shots and take a wait and see approach.... The last shot I did not get the full amount due to the swelling underneath.

Re: Alcohol sclerosing injections anyone?

Dr. Z on 11/25/05 at 17:52 (188191)

Cindyh
What is going on with the injections?. The amount of fluid should be very small and by now you should have alot of relief or its times to re-evaluate what is going on with your foot

Re: Alcohol sclerosing injections anyone?

cindyh on 11/26/05 at 06:02 (188216)

Hi Dr. Z,

I am feeling releif some releif. I would say 98%. The only discomfort is this lump underneath in the fat pad of the bal of my foot. I think you are right. My incling is that it is time to stop and take a wait and see approach to see how things go from here. Thanks for the comment.

Re: Alcohol sclerosing injections anyone?

Jacquie D. on 12/01/05 at 13:58 (188628)

I finished the entire 8 week injection treatment and feel that I am now 98% pain free! The injections were a breeze, just had to not fitness walk for the first two days after each one. I am VERY hopeful that I will be able to avoid surgery (that was the next step for me).

Re: Alcohol sclerosing injections anyone?

Nancy M. on 12/08/06 at 08:31 (216925)

Hi! I'm thankful to read everyone's comments. I'd like some feedback from anyone.... I'm on my second shot. The shots do not bother me; that type of pain usually does not. After the first shot, my foot was very sore, but I assumed this was more from the vigorous examination that proceeded the injection. My foot was back to it's normal pain the next morning. :) HOWEVER, this second injection is completely different. The next morning I got on my foot and walked as normal and the sharp, burning pain was intense. It is swollen on the bottom and on day 2 I still can not put weight on it. My doc has not been very helpful. Is this a normal reaction? Thanks!