Pain in the forefoot that feels like burning, tingling, numbness, cramping in the toes, or the sensation of a wadded sock under the ball of the foot is very typical of a neuroma. A neuroma is an irritation and inflammation of a nerve, most often located in the forefoot. In my clinical experience, this condition is commonly linked to poor foot mechanics, frequent use of high heels, unsupportive footwear, or shoes that are too narrow and compress the forefoot.

Sclerosing injections, also known as alcohol injections or chemical neurolysis, are a non-surgical treatment designed to shrink the affected nerve tissue and reduce pain. This is an office-based procedure. A dilute alcohol solution, typically 4% ethanol, is combined with a local anesthetic such as Novocain and injected around the neuroma. The alcohol works by chemically dehydrating and scarring the nerve, which ultimately reduces its ability to transmit pain signals.

Treatment is delivered as a series of injections rather than a single visit. Most patients receive between three and seven injections, spaced one to two weeks apart. Ultrasound guidance is often used to place the injection precisely around the nerve for improved accuracy.

Clinical data show strong outcomes with this approach. Published reviews report success rates of up to 80% in relieving neuroma pain. In a large patient series, 82% of patients became completely pain-free after completing the injection series. 

For many individuals, this treatment provides significant relief and may help them avoid open surgery.

No. The injection is done under local anesthesia, so most patients feel only a quick pinch. In fact, experts report that this injection is often less painful than a standard cortisone shot. As one clinic explains, “patients do not feel any burn from the alcohol” during the injection because the local anesthetic numbs the area. 

After the shot, once the numbing wears off, a small burning or aching sensation may be felt as the alcohol works on the nerve. However, virtually all patients say any burning is minor and brief. 

In summary, you should not expect severe pain during the procedure. The most you might feel is a momentary sting from the needle, and minor burning afterward – both of which quickly subside.

After each injection, it’s normal to have some localized soreness or tenderness. Applying ice to the foot and resting helps reduce any swelling or pain immediately afterwards. 

Many patients notice numbness in the toes supplied by the treated nerve. As the alcohol takes effect, it gradually silences the nerve, so you may feel “sequentially increased numbness” in the adjacent toes. Most people describe this numb feeling as very mild – they often prefer mild numbness to the original burning pain.

Some patients do experience a temporary flare of nerve pain in the days after the first injection. This is usually worst after the very first shot and often feels like a deep ache. Continuing the planned series of injections tends to calm this nerve pain over time. 

By the end of the series, most patients find their original neuroma pain is much improved or gone, even if their toes feel slightly numb.

After your injection, follow your doctor’s care instructions closely. In general:

• Plan to rest the foot for at least 24 hours. 
• Apply an ice pack (wrapped in a thin cloth) to the injection site for 15–20 minutes every 2 hours on the first day. 
• It’s normal to feel some ache after the anesthetic wears off. You can take over-the-counter NSAIDs (like ibuprofen) or acetaminophen for discomfort.

Following these steps helps ensure a smooth recovery. Most patients find that any redness or swelling resolves on its own in a few days. You will return for the next injection in the series (usually in 1–2 weeks) as recommended by your physician.

If you or a loved one is suffering from a painful neuroma and wants to avoid surgery, call Central Florida Foot and Ankle Center, LLC today. 

We have expert podiatrists at offices in Winter Haven, Lakeland, and Davenport, FL, who offer same-day appointments. Our team can evaluate your foot, discuss whether sclerosing injections might help you, and design a complete treatment plan. 

Don’t let neuroma pain hold you back – call us to learn about this minimally invasive option.