Efficacy of Foot Orthoses in Treatment of Interdigital Neuroma
Research type
Research Study
Full title
The effectiveness of foot orthoses with metatarsal domes in the treatment of Interdigital neuroma.
IRAS ID
158438
Contact name
Bev Durrant
Contact email
Duration of Study in the UK
1 years, 0 months, 0 days
Research summary
Interdigital neuromas are a common cause of forefoot pain affecting the webspaces of the toes and are more prevalent in females than males. This condition is very often treated by a staged approach using a combination of conservative care (foot orthoses or injections) and surgery. Orthoses (special insoles to wear in shoes) with a metatarsal dome or pad are designed to relieve pressure from the neuroma by splaying and lifting the metatarsal heads. Referral for a corticosteroid injection and ultrasound scan is usually made if there is no improvement in symptoms with orthoses after 8 weeks. Referral for surgery for excision of the neuroma is the last option if the former interventions fail.
The Cochrane review, Thompson, Gibson and Martin (2011) stated that there is no consensus on the best treatment of interdigital neuroma and suggested that this is an area for future research. There is conflicting evidence for conservative and surgical treatments. The use of foot orthoses has a cost implication for the NHS and it is therefore important to establish this practice as effective. This study aims to make a comparative analysis between a treatment group issued with orthoses and a non-treatment group acting as a control.
A total of 60 participants (30 for treatment group and 30 for control) will be recruited from an NHS Podiatry service at an assessment appointment which will take place in an NHS community clinic. Patients will be invited to participate in the study if given a positive diagnosis of interdigital neuroma on assessment and if they meet the inclusion criteria and are happy to consent to the study. Outcomes will be recorded using a questionnaire with three sub scales of The Revised Foot Function Index short form (FFI-R S) which participants will complete at assessment appointment and again after 8 weeks.
REC name
HSC REC B
REC reference
15/NI/0100
Date of REC Opinion
21 May 2015
REC opinion
Favourable Opinion