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Chemical Neurolysis for the Treatment of Neuromas

Written By: Kirk A. Koepsel, D.P.M. Editor, PodiatryNetwork.com

Description

The chemical destruction of the nerve, called neurolysis, is an older form of treatment that has recently come back into vogue. This treatment consists of seven weekly injections of ethanol mixed with a local anesthetic. The injections are given into the area of the neuroma. Nerve tissue has a natural affinity for ethanol, and it is readily absorbed into the nerve. Ethanol, however, is toxic to nerve tissue and with repeated exposure, will destroy the nerve. The rate of success is variable, but has been reported to be over 60%. Many insurance plans will not pay for weekly injections and require the doctor to wait a minimum of ten days between injections before they will reimburse for the procedure. This likely reduces the rate of success for this treatment, because during the time between the injections, the nerve will attempt to repair itself. One way to solve this delay is for the patient to pay for those injections not paid for by the insurance plan. The disadvantages for this form of treatment are the need for repeated visits to the doctor's office, and the occasional pain in the area of the injection the following day or two after it has been administered. The advantages to this form of treatment is that it requires a minimal amount of time off of work and the overall cost as compared to the surgical removal of the nerve. If this form of treatment fails, then surgical removal is the only option that remains.

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