Reduced foot pain after spasticity control with alcohol block in a patient with chronic hemiparetic stroke: a case report.
Min Cheol Chang
PMID 28533627WHAT IT FOUND
A 58-year-old woman with chronic stroke and severe foot pain from a Tailor's bunion reported pain dropping from 8/10 to 1/10 after alcohol nerve blocks reduced her ankle spasticity.
The block was combined with stretching, so the independent effect of the alcohol injection remains unclear.
Key findings
01Pain at the fifth metatarsal head decreased from a numeric rating scale score of 8 to 1 two weeks after the procedure, and this reduction was sustained at one, two, and three months.
02Ankle spasticity, initially graded as Modified Ashworth Scale 1+, disappeared (MAS 0) two weeks after the block, and ankle clonus was no longer present.
03Dynamic foot pressure during walking shifted from being highly concentrated in the lateral forefoot to a distribution similar to that of a normal control subject.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
This is a single case report, so the findings cannot be generalised to other patients. The patient received stretching exercises for two weeks after the alcohol block. The authors acknowledge that stretching is known to reduce spasticity, so it is impossible to determine how much of the pain and spasticity reduction was due to the alcohol block versus the stretching exercises. There was no control group or comparison intervention. The study did not report on potential adverse effects or complications of the alcohol nerve blocks.
Declared interests
The text does not report any funding sources or conflicts of interest.
The easy way to misread this
Do not conclude that alcohol nerve blocks are an established treatment for foot pain in stroke patients. This is a single case report where the block was combined with stretching exercises, and the contribution of each component to the pain reduction cannot be separated.