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Extracorporeal Shockwave Therapy for Interdigital Neuroma

A Randomized, Placebo-Controlled, Double-Blind Trial

Robert Fridman Department of Orthopaedic Surgery, Columbia University Medical Center, New York, NY; private practice, New York, NY.

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Jarrett D. Cain Private practice, Yeadon, PA.

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Lowell Weil Jr. Weil Foot and Ankle Institute, Des Plaines, IL.

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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)

Corresponding author: Lowell Weil, Jr., DPM, MBA, Weil Foot and Ankle Institute, 1455 Golf Rd, Des Plaines, IL 60016. (E-mail: weiljr@aol.com)