Abstract Painful digital neuromas are an uncommon but debilitating cause of chronic neuropathic hand pain. Symptoms often persist despite conservative management, and surgical revision is associated with variable outcomes and a significant risk of recurrence. Minimally invasive, nerve-targeted interventions may offer effective pain relief while avoiding additional surgical morbidity. Reporting successful alternative approaches is important to inform clinical decision-making in selected refractory cases. We report the case of a 49-year-old Indian woman with severe, refractory neuropathic pain of the right index finger following prior surgery for a presumed glomus tumour. Clinical features and high-resolution ultrasonography confirmed a symptomatic digital neuroma. Given persistent symptoms and the unpredictable outcomes of repeat surgery, landmark-guided micro-volume phenol neurolysis was performed using a 26-gauge needle and 0.2 mL of 6% phenol. The patient experienced rapid and marked pain relief, with sustained functional improvement and no complications. This case demonstrates that micro-volume phenol neurolysis may offer a minimally invasive option for pain relief in carefully selected patients with painful digital neuromas. As a low-morbidity technique, it may represent a valuable therapeutic option when conservative measures fail, and surgical revision is undesirable. However, larger studies are required to establish its effectiveness, define appropriate patient selection and determine long-term outcomes.
Sheenam et al. (2026) studied this question.