There is limited evidence that steroid injections work long term, especially when performed in isolation. There is an improved response in patients who have a larger bursa as well as a neuroma, in which case the injection should target the bursa. We have found that an injection is more likely to work long term if combined with other treatments that address associated instability of the foot.

We would not recommend more than two injections per year. Unfortunately, steroid injections are associated with a number of possible complications including soft tissue wastage (fat atrophy), which can cause tenderness on the ball of the foot. Other risks include skin discolouration and damage to tendons, ligaments and joints. A patient who has not responded to two injections is very unlikely to respond to further ones. Cryosurgery does not have the side effects of steroid injections and is therefore a preferable form of treatment.

We do not endorse these treatments currently. More information on this can be found in the injection treatment section.