Midfoot Pains – Response to Injection

Over 1/2 of patients will get sustained relief of midfoot pain for 3 months with steroid injection

Skeletal Radiol. 2011 Aug;40(8):1001-6. Epub 2011 Jan 28.
Efficacy of ultrasound-guided steroid injections for pain management of midfoot joint degenerative disease.
Drakonaki EE, Kho JS, Sharp RJ, Ostlere SJ.  abstract here

  • 59 cases of degenerate midfoot joint disease (tarsometatarsal, calcaneocuboid, naviculocuneiform, and talonavicular joints)
  • midfoot tenderness and pain; occasional swelling
  • 71.4% showed degenerative changes on xray
  • Steroid injection – under ultrasound control (not really necessary I think, but necessary for a study)
  • Bupivacaine hydrochloride 0.5% 1-1.5 ml and 20-40 mg Depomedrone
  • 67.5% positive response at 4 weeks and 57.5 % at 1-3 months

Comment – another tool – but needs repeating in 3 months; might work better if treatment associated with midfoot mobilizations: – grip one sie of foot with one hand and the other with other hand – push one side up and other side down – I find it helps to put the side that’s going up on my knee and push up with my knee as well – when I do it. Then, when I do the oppposite direction, switch my knee placement.

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