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Hassouna H, Singh D: Morton’s metatarsalgia: pathogenesis, aetiology and current management. .Acta Orthop Belg 71::646. ,2005. .
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Weinfeld SB, Myerson MS: Interdigital neuritis: diagnosis and treatment. .J Am Acad Orthop Surg 4::328. ,1996. .
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Barrett SL, Walsh AS: Endoscopic decompression of intermetatarsal nerve entrapment: a retrospective study. .JAPMA 96::19. ,2006. .
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Thomson CE, Gibson JN, Martin D, et al: Interventions for the treatment of Morton’s neuroma. .Cochrane Database Syst Rev 3::CD003118. ,2004. .
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Coombs R, Schaden W, Zhou SSH: “Introduction,” in Musculoskeletal Shockwave Therapy, ed by R Coombs, et al, p xxxvii, Greenwich Medical Media, London. ,2000. .
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Delius M: Medical applications and bioeffects of extracorporeal shock waves. .Shock Waves 4::55. ,1994. .
Extracorporeal Shockwave Therapy for Interdigital Neuroma
A Randomized, Placebo-Controlled, Double-Blind Trial
Background: We sought to evaluate the safety and effectiveness of extracorporeal shockwave therapy as a therapeutic treatment for destroying Morton’s neuroma.
Methods: Twenty-five patients (25 feet) were included in the study. Indications for participation were more than 8 months of conservative care with a visual analog scale pain score of 4 or greater. The mean overall pain score on a modified visual analog scale was 6.9 preoperatively.
Results: Thirteen patients were randomized to the active group and 12 to the sham group. Two patients in the sham group were lost to follow-up. Post-treatment evaluations were performed at 1, 6, and 12 weeks by a blinded investigator (L.W.). The end point evaluation parameter was the reduction in visual analog scale score. The treatment group showed a significant difference before and after extracorporeal shockwave therapy (P < .0001). The sham group did not have a significant difference after 12 weeks (P = .1218).
Conclusions: Extracorporeal shockwave therapy is a possible alternative to surgical excision for Morton’s neuroma. (J Am Podiatr Med Assoc 99(3): 191–193, 2009)
