A randomized, double-blind, placebo-controlled trial of injected capsaicin for pain in Morton's neuroma
Autor: | James N. Campbell, Eric Diamond, Robert R. Allen, Margaret Kelly, William Houghton, Kerrie L. Brady, Claudia M. Campbell, William K. Schmidt |
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Rok vydání: | 2016 |
Předmět: |
Adult
Male medicine.medical_specialty Morton Neuroma Analgesic Morton's neuroma Placebo 03 medical and health sciences 0302 clinical medicine Double-Blind Method medicine Humans Local anesthesia Aged business.industry Middle Aged medicine.disease Neuroma Surgery Treatment Outcome Anesthesiology and Pain Medicine Neurology 030220 oncology & carcinogenesis Anesthesia Neuropathic pain Neuralgia Female Neurology (clinical) Capsaicin business 030217 neurology & neurosurgery |
Zdroj: | Pain. 157:1297-1304 |
ISSN: | 0304-3959 |
Popis: | Intermetatarsal neuroma or Morton's neuroma is a painful condition of the foot resulting from an entrapment of the common digital nerve typically in the third intermetatarsal space. The pain can be severe and especially problematic with walking. Treatment options are limited and surgery may lead to permanent numbness in the toes. Capsaicin, the pungent ingredient of hot peppers, produces analgesia by inducing retraction of nociceptive afferents from the area of innervation and is effective in treating certain neuropathic pain disorders. A randomized double-blind placebo-controlled study was conducted to test the efficacy, tolerability, and safety of a single 0.1 mg dose of capsaicin vs placebo injected into the region of the neuroma. A total of 58 subjects diagnosed with Morton's neuroma with foot pain ≥4 (0-10 numerical pain rating scale) were injected with 2 mL of lidocaine into the intermetatarsal space proximal to the neuroma to provide local anesthesia. After 5 minutes, 0.1 mg capsaicin or placebo was injected into the intermetatarsal space containing the painful neuroma. Average foot pain was rated for 2 weeks before through 4 weeks after injection. At weeks 1 and 4, the decrease in pain was significantly greater in the subjects treated with capsaicin (P = 0.021 and P = 0.019, respectively). A trend toward significance was noted at weeks 2 and 3. Improvements in functional interference scores and reductions in oral analgesic use were also seen in the capsaicin-treated group. These findings suggest that injection of capsaicin is an efficacious treatment option for patients with painful intermetatarsal neuroma. |
Databáze: | OpenAIRE |
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