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Oral preparations of Vitamin B12 may increase serum levels but many patients remain symptomatic until they use sublingual or vitamin B12 injections due to low cellular concentrations 6

At the same time, it is important to assess the width of shoes as they may be exacerbating the neuroma if they are narrower than the width of the foot

Injections: One or more medicated steroid B12 injections which act to reduce inflammation resulting in pain relief or alcohol sclerosing injections to induce nerve degeneration and or destruction

Rather than offering an uploading course, (one injection per week for 4 weeks) to your client, you can offer a course of four injections to be used as and when your client requires