Addante JB, Peicott PS, Wong KY, et al: Interdigital neuromas: results of surgical excision of 152 neuromas. JAPMA 76: 493, 1986.
Bartolomei FJ, Wertheimer SJ: Intermetatarsal neuromas: distribution and etiologic factors. J Foot Surg 22: 279, 1983.
Finney W, Wiener SN, Catanzariti F: Treatment of Morton's neuroma using percutaneous electrocoagulation. JAPMA 79: 615, 1989.
Goldman F: Intermetatarsal neuromas: light and electron microscopic observation. JAPA 70: 265, 1980.
Moore JL, Rosen R, Cohen J, et al: Radiofrequency thermoneurolysis for the treatment of Morton's neuroma. J Foot Ankle Surg 51: 20, 2012.
Sluijter ME: The role of radiofrequency in failed back surgery patients. Curr Rev Pain 4: 49, 2000.
Slappendel R, Crul BJ, Braak GJ, et al: The efficacy of radiofrequency lesioning of the cervical spinal dorsal root ganglion in a double blinded randomized study: no difference between 40 degrees C and 67 degrees C treatments. Pain 73: 159, 1997.
Rozen D, Ahn J: Pulsed radiofrequency for the treatment of ilioinguinal neuralgia after inguinal herniorrhaphy. Mt Sinai J Med 73: 716, 2006.
Bogduk N: Pulsed radiofrequency. Pain Med 7: 396, 2006.
Van Zundert J, de Louw AJ, Joosten EA, et al: Pulsed and continuous radiofrequency current adjacent to the cervical dorsal root ganglion of the rat induces late cellular activity in the dorsal horn. Anesthesiology 102: 125, 2005.
Restrepo-Garces CE, Marinov A, McHardy P, et al: Pulsed radiofrequency under ultrasound guidance for persistent stump-neuroma pain. Pain Pract 11: 98, 2011.
Byrd D, Mackey S: Pulsed radiofrequency for chronic pain. Curr Pain Headache Rep 12: 37, 2008.
Tekin I, Mirzai H, Ok G, et al: A comparison of conventional and pulsed radiofrequency denervation in the treatment of chronic facet joint pain. Clin J Pain 23: 524, 2007.
Basal S, Ergin A, Yildirim I, et al: A novel treatment of chronic orchialgia. J Androl 33: 22, 2012.
Basal S, Goktas S, Ergin A, et al: A novel treatment modality in patients with premature ejaculation resistant to conventional methods: the neuromodulation of dorsal penile nerves by pulsed radiofrequency. J Androl 31: 126, 2010.
Atim A, Deniz S, Kurt E: Re: coccygodynia. Pain Pract 11: 507, 2011.
Lee KT, Kim JB, Young KW, et al: Long-term results of neurectomy in the treatment of Morton's neuroma: more than 10 years' follow-up. Foot Ankle Spec 4: 349, 2011.
Valente M, Crucil M, Alecci V: Operative treatment of interdigital Morton's neuroma. Chir Organi Mov 92: 39, 2008.
Genon MP, Chin TY, Bedi HS, et al: Radio-frequency ablation for the treatment of Morton's neuroma. ANZ J Surg 80: 583, 2010.
Schreiber K, Khodaee M, Poddar S, et al: Clinical inquiry: what is the best way to treat Morton's neuroma? J Fam Pract 60: 157, 2011.
Cosman ER Jr, Cosman ER Sr: Electric and thermal field effects in tissue around radiofrequency electrodes. Pain Med 6: 405, 2005.
Hagiwara S, Iwasaka H, Takeshima N, et al: Mechanisms of analgesic action of pulsed radiofrequency on adjuvant-induced pain in the rat: roles of descending adrenergic and serotonergic systems. Eur J Pain 13: 249, 2009.
Van Zundert J, Patijn J, Kessels A, et al: Pulsed radiofrequency adjacent to the cervical dorsal root ganglion in chronic cervical radicular pain: a double blind sham controlled randomized clinical trial. Pain 127: 173, 2007.
Van Zundert J, Brabant S, Van de Kelft E, et al: Pulsed radiofrequency treatment of the Gasserian ganglion in patients with idiopathic trigeminal neuralgia. Pain 104: 449, 2003.
Coughlin MJ, Pinsonneault T: Operative treatment of interdigital neuroma: a long-term follow-up study. J Bone Joint Surg Am 83: 1321, 2001.
Cahana A, Van Zundert J, Macrea L, et al: Pulsed radiofrequency: current clinical and biological literature available. Pain Med 7: 411, 2006.
Morton's neuroma is a perineural fibrosis of an intermetatarsal plantar nerve. Burning, numbness, paresthesia, and tingling down the interspaces of involved toes may also be experienced. Taking into account all of this information, we designed a prospective open-label study to evaluate the efficacy of pulsed radio frequency on Morton's neuroma.
Twenty patients with Morton's neuroma were experiencing symptomatic neuroma pain in the foot not relieved by routine conservative treatment. All of the patients had been evaluated by a specialized orthopedist and were offered pulsed radio frequency as a last option before having surgery. Initially, pain level (numerical rating scale), successful pain control (a ≥50% pain decrease was accepted as successful pain control), comfort when walking (yes or no), and satisfaction level (satisfied or not satisfied) were evaluated.
We found a decrease in the pain level in 18 of 20 patients, successful pain control in 12, and wearing shoes and walking without pain in 16. Overall, satisfaction was rated as excellent or good by 12 patients with Morton's neuroma in this series.
This evidence indicates that ultrasound-guided pulsed radio frequency is a promising treatment modality in the management of Morton's neuroma pain.