Combining Pulsed and Conventional Radiofrequency Ablation for Resistant Morton’s Neuroma: A Case Report and Literature Review

TL;DR

A 61-year-old man with resistant Morton’s neuroma experienced long-term pain relief using a combination of pulsed and conventional radiofrequency treatments.

Contribution

This is the first reported case using a combined pulsed and conventional radiofrequency approach for Morton’s neuroma.

Findings

The patient reported significant pain reduction with NRS scores of 1 at two weeks and one month, and 2 at seven months.

The combined PRF and CRF treatment provided a viable alternative to surgery for refractory Morton’s neuroma.

The treatment protocol involved sequential temperatures of 42°C, 60°C, and 70°C for specific durations.

Abstract

Morton's neuroma is a painful, degenerative neuropathy that is initially managed with conservative treatments. In refractory cases, surgical excision is typically indicated. Minimally invasive percutaneous procedures provide a viable alternative to surgery.

While both pulsed radiofrequency (PRF) and conventional radiofrequency (CRF) have been individually reported as effective treatments for Morton’s neuroma, we aim to utilize a combination of PRF and CRF for pain management.

We report the case of a 61-year-old male with a five-year history of right foot Morton’s neuroma, presenting with severe pain that was refractory to conservative management, including multiple corticosteroid injections. Radiofrequency was performed as follows: 5 minutes at 42°C, 1 minute at 60°C, and 1 minute at 70°C.

The patient experienced significant pain relief, with follow-up Numerical Rating Scale (NRS) of 1 at two weeks, 1 at one month, and 2 at seven months post-treatment.

This case suggests that the combined application of PRF and CRF may serve as a promising alternative for managing refractory Morton’s neuroma.