Promising Outcomes of Ultrasound-Guided Pulsed Radiofrequency for the Treatment of Morton's Neuromas - A Prospective Study

Abstract

Background: Morton's neuroma is a compressive neuropathy of the common plantar digital nerve, causing significant pain and limiting patients' activities.

Objectives: This study aimed to investigate the effect of pulsed radiofrequency (PRF) on the pain, functionality, and quality of life experienced by patients with Morton's neuroma.

Study design: This was a prospective study with pre- and post-intervention assessments after one, 3, and 6 months of treatment.

Setting: The orthopedics department of an affiliated hospital.

Methods: Patients with Morton's neuroma underwent treatment with ultrasound-guided PRF in 2 sites around the neuroma for 8 minutes. Clinical outcomes were assessed using the visual analog scale (VAS), the American Orthopedic Foot and Ankle Society (AOFAS) questionnaire for assessing foot function, and the Short Form-36 (SF-36) for quality of life.

Results: A total of 20 patients (29 feet) completed the 6-month minimum follow-up period. The VAS and face scale values at follow-up were statistically lower than the pre-procedure VAS scores (P < 0.05). The AOFAS and SF-36 values at follow-up were statistically higher than the pre-procedure values (P < 0.05). No significant adverse events were recorded during the follow-up.

Limitations: The prospective research features a limited follow-up duration and lacks an additional group, whether control or treatment, for result comparisons.

Conclusion: Applications of PRF decreased the pain and the improved functionality and quality of life experienced by patients with Morton's neuroma for a 6-month follow-up at minimum.

Keywords: forefoot pain; Morton’s neuroma; metatarsalgia; neuromodulation; neuropathic pain; non-surgical intervention; pulsed radiofrequency; Compression neuropathy.