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. 2015 Jun;14(2):90-8.
doi: 10.1016/j.jcm.2015.04.003. Epub 2015 Jun 24.

Manipulation in the Treatment of Plantar Digital Neuralgia: A Retrospective Study of 38 Cases

David G Cashley  1 , Lynda Cochrane  2
Affiliations

Manipulation in the Treatment of Plantar Digital Neuralgia: A Retrospective Study of 38 Cases

David G Cashley et al. J Chiropr Med. 2015 Jun.

Abstract

Objective: The purpose of this retrospective case series is to describe treatment outcomes for patients with plantar digital neuralgia (PDN) (Morton's neuroma) who were treated using foot manipulation.

Methods: Charts were reviewed retrospectively for patients with a diagnosis of PDN and who received a minimum of 6 treatments consisting of manipulation alone. Visual analogue pain scales (VAS) and pressure threshold meter readings (PTM) were extracted as outcome measures.

Results: Thirty-eight cases met inclusion criteria. Mean pretreatment duration of pain was 28 months. Mean pretreatment VAS was 69.5/100 mm. Mean pretreatment PTM was 2.54 Kp. By the sixth treatment, 30 (79%) of the 38 patients scored a VAS of 0 mm and a further 4 (10%) were below 10 mm. Contralateral limb PTM showed a mean pre-treatment score of 5.5 Kp, which rose slightly to 5.85 Kp. This compared to a pre-treatment score of 2.54 Kp rising to 5.86 Kp in the affected limb. This represents a 126% increase in the affected side compared to 6.5% in the unaffected limb. Statistical analysis demonstrated a significant linear trend between decreasing VAS and manipulation (P < .001).

Conclusion: The patients with PDN who were included in this case series improved with conservative care that included only foot manipulation.

Keywords: Foot; Musculoskeletal manipulations; Neuroma.

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Figures

Fig 1
Fig 1
Box plot of VAS during treatment. VAS, visual analogue pain scale.
Fig 2
Fig 2
Error bar chart of PTM during treatment. PTM, pressure threshold meter readings.
Fig 3
Fig 3
Scatter plot of PTM and VAS in symptomatic patients (all readings). PTM, pressure threshold meter readings; VAS, visual analogue pain scale.
See this image and copyright information in PMC

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