Distal traction may be applied to the great toe to open the joint space. The needle is inserted on the dorsomedial or dorsolateral surface ( Figure 6 ) . The needle should be angled 60 to 70 degrees to the plane of the foot and pointed distally to match the slope of the joint. The joint space is not deep below the skin surface. The physician should aspirate before injecting; the injectable agent should flow without major resistance when the needle is positioned properly in the joint space. Follow-up care is the same as that previously described.
I had three injections all of which worked for a few days to two weeks then stopped. The excruciating pain returned and only Vicoden 5 mg 3-4 times a day controlled the pain. Vicoden at that dose is the lowest dose prescribed. it worked perfectly for several years and doctors refused to prescribed opioids for fear of losing their license. My sister recently died of throat cancer and she complained constantly of pain. She died with unrelieved pain. As a cancer patient she was prescribed Morphine 2 mg. every 6 hours. That is beyond ridiculous but keeps our doctor’s license safe. Our doctors are violating their Hippocratic oath – Do No Harm. They had added a caveat “except when the government is breathing down your neck. Then the patient be damned. I am glad this helped you Randy. I don’t know your clinical status but I am sure it differs from mine. Do you have severe and crippling arthritis?