Radiofrequency Ablation for the Management of Morton's Neuroma

NewsBot · May 18, 2017

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Three Cycles of Radiofrequency Ablation Are More Efficacious Than Two in the Management of Morton's Neuroma.
Brooks D, Parr A, Bryceson W
Foot Ankle Spec. 2017 May 1:1938640017709905. doi: 10.1177/1938640017709905

BACKGROUND:
Morton's neuroma is a common cause of forefoot pain. Outcomes of conservative therapy are mixed and many patients undergo operative intervention. Radiofrequency ablation has recently gained favor as a treatment option, although the optimal regime is unknown. This study investigates the effectiveness of 2 versus 3 cycles of radiofrequency ablation for the treatment of Morton's neuroma.
METHODS:
We surveyed a cohort of patients with Morton's neuroma who had progressed to radiofrequency ablation after failed conservative treatment. Patients received either 2 or 3 cycles of radiofrequency ablation by a single surgeon. We assessed patients based on their change in numerical pain rating scale, symptom improvement, complications, and progression to surgical excision through a series of telephone interviews. Outcomes between the 2 treatment arms were compared by parametric tests.
RESULTS:
Twenty-eight patients were included in the study. Eighteen patients with 21 neuromas received 2 cycles and 10 patients with 11 neuromas received 3 cycles. Mean time of follow-up was 12.9 months. Overall, 88% of patients were either very or moderately satisfied with their outcome. In patients who received 2 cycles mean numerical pain scores decreased from 7.9 ± 1.1 to 3.4 ± 2.4 postprocedure. Three patients progressed to operative excision. In patients who received 3 cycles, numerical pain scores decreased from 8.0 ± 1.0 to 1.5 ± 2.0 postprocedure. One patient progressed to operative excision. Patients who received 3 cycles had reduced medium-term pain postoperatively compared with 2 cycles (3.4 ± 2.4 vs 1.5 ± 2.0, P = .011).
CONCLUSION:
Radiofrequency ablation provides a high rate of patient satisfaction in the treatment of Morton's neuroma with few side effects. It appears that 3 cycles may be superior to 2 cycles but a randomized controlled trial will be required to confirm these results.
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Admin2 · May 18, 2017

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NewsBot · Oct 3, 2017

Ultrasound-Guided Percutaneous Radiofrequency for the Treatment of Morton’s Neuroma
Salvatore Masala et al
CardioVascular and Interventional Radiology 27 September 2017

Purpose
Morton’s neuroma (MN) is a leading cause of disability. The purpose of this study was to investigate the effectiveness of radiofrequency (RF) in patients with chronic pain refractory to conservative therapies.

Methods
Between September 2012 and December 2016, RF was performed on 52 patients. A sterile RF needle probe (22G, 5-cm needle with 10-mm electrode active tip) was inserted between the toes into the intermetatarsal space at the center of the lesion. Potential complications of the intervention and post-procedure care were examined. All patients provided written, informed consent. All percutaneous procedures were performed with the NeuroTherm® NT1100 (Neurotherm Inc., M.) device and using ultrasound guidance (Philips IU22). Continuous RF was performed with one cycle of 90 s and with the probe tip maintaining a temperature of 85 °C (impedance 95–210 mΩ).

Results
Mean VAS score before the procedures was 9.0 ± 0.6. A reduction of pain intensity was achieved after 1 week by RF (mean VAS scores 3.7 ± 0.9; p < 0.05), with a stabilization of the painful symptomatology in the following months and after 1 year of treatments (mean VAS scores 2.0 ± 0.4 after 12 months, p < 0.05). The FHSQ scores showed improved quality of life (QOL) in all patients at 6 months (p < 0.05) and 1 year (p < 0.05) of RF. No patients developed complications.

Conclusions
RF is a safe, efficient, and minimally invasive technique for the treatment of symptomatic MN.
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NewsBot · May 8, 2018

Ultrasound guided radiofrequency ablation of Morton’s neuroma: A substitute for surgery
Ahmed M. Bassiouny
The Egyptian Journal of Radiology and Nuclear Medicine; 3 May 2018

Objectives
To assess the efficacy of radiofrequency ablation of Morton's neuroma (MN) as a substitute to surgery, in patients not responding to conservative treatment.

Methods
15 patients, who performed radiofrequency ablation (RFA) of Morton's neuroma between November 2015 and December 2016, were submitted to follow up to assess the response to therapy over a period of 6 months by assessment of pain relief through visual analogue scale (VAS) scale from 1 to 10 from least to severe pain.

Results
All of the 15 patients suffered from intense pain during their normal daily activity prior to RF ablation, pretreatment VAS average was 7.

Follow up of the patients was done after 1 week, 1 month, 3 months and 6 months.

After RF ablation, pain disappeared in 9 cases (60%), 3 had mild pain (20%), 2 moderate pain (13.3%) and 1 with severe pain (6.6%) and proceeded to surgery. Complete resolution of pain was encountered in the patients with mild and moderate pain with conservative or second session of RFA.

Conclusion
Radiofrequency ablation of Morton's neuroma, is an effective technique in treatment of symptomatic patient's after failure of conservative treatment and prior to surgical intervention.
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NewsBot · Aug 14, 2019

Ultrasound-guided radiofrequency ablation for treatment of Morton's neuroma: initial experience
R.ShahaM.AhmadaD.Hanu-CernatbS.Choudharya
Clinical Radiology; 10 August 2019

Highlights
•Ultrasound guided radiofrequency ablation is a safe and effective treatment for symptomatic Morton‘s neuroma of the foot.
•Real time US guidance during continuous radiofrequency demonstrating an ‘ablation zone’ helps guide duration of RFA treatment.
•Further studies on long term outcomes and comparison to other management options will be required to establish its role in management of symptomatic Morton's neuroma.
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AIM
To assess the efficacy and safety of ultrasound-guided radiofrequency ablation (RFA) for treatment of symptomatic Morton's neuroma.

MATERIALS AND METHODS
Patients with symptomatic Morton's neuroma of the foot were referred for treatment with RFA, prior to consideration for surgery. All neuromas were proven by ultrasound imaging and had a trial of conservative management including orthotic support and/or steroid injections. Ultrasound-guided RFA was performed as an outpatient procedure under local anaesthetic. Patients were followed up at 8 weeks and 8 months. Outcomes were assessed with a visual analogue scale (VAS) score, Manchester–Oxford Foot and Ankle Questionnaire, overall patient satisfaction, and complications.

RESULTS
Twenty-two neuromas were treated with RFA under ultrasound guidance. The VAS score at 8 weeks was significantly lower than the VAS score pre-procedure (p<0.001, Wilcoxon signed ranks test) and the VAS score at 8 months was significantly lower than the VAS score at 8 weeks (p=0.008, Wilcoxon signed ranks test). At 8 months, 89% of treated patients were satisfied with the procedure outcome. No significant adverse effects were recorded.

CONCLUSION
Ultrasound-guided RFA is safe, with excellent initial results in treatment of symptomatic Morton's neuroma. Further studies on long-term outcomes and comparison to other management options will be required to establish its role in management of symptomatic Morton's neuroma.
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NewsBot · May 3, 2020

Radiofrequency Ablation for the Treatment of Painful Neuroma.
Connors JC et al
J Foot Ankle Surg. 2020 May - Jun;59(3):457-461

Mechanical compression of interdigital nerves beneath the deep transverse intermetatarsal ligament and between the metatarsal heads leads to painful irritation and possible fibrosis. Conservative measures of padding and injections often fail to provide long-term relief. Surgical excision provides definitive relief, but the procedure is not without risk. Incomplete excision and stump neuroma formation are a few of the possible complications associate with open excision. This retrospective cohort study was performed to provide a review of the available literature on the identification and treatment of interdigital neuromas and to examine the overall incidence of patient satisfaction after radiofrequency ablation as definitive treatment for interdigital neuroma formation. This study population consisted of 32 patients (25 females and 7 males with 1 patient having bilateral procedures) with a mean age of 46.3 ± 17 (range 31 to 65) years. For all procedures, the median patient satisfaction score was 92.5 (interquartile range 50 to 100) of 100, with a mean follow-up period of > 2.5 years. Only 1 patient in the study population reported no relief after 3 total procedures. Radiofrequency ablation offers a minimally invasive alternative with a short postoperative recovery course and considerably fewer complications compared with surgical excision of the intermetatarsal neuroma as described in prior reports.
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NewsBot · Jun 22, 2025

The role of radiofrequency therapy in the treatment of Morton's neuroma: A case report
Romy Deviandri et al
International Journal of Surgery Case ReportsVolume 131, June 2025, 111424

Highlights

• Morton Neuroma is one of the rare condition which affect interdigital nerve.
• Performing a minimal invasive approach may improve patient's quality of life.
• Pulsed Radiofrequency was chosen to minimize progressed pain of foot.
• Foot and Ankle Disability Index and Visual Analog Scale indicate favorable results.

Introduction and importance
Morton's Neuroma is a neuropathy of the forefoot, specifically located on the interdigital nerve, and is associated with the thickening of the intermetatarsal ligament and nerve fibrotic. The management of Morton's Neuroma is challenging. Various treatments have been introduced for treating this lesion, starting from conservative treatment using the metatarsal pad, physical therapy, and corticosteroid injection to surgical treatment. This report highlights a novel approach to Morton's Neuroma using a pulsed radiofrequency (PRF).
Case presentation
A 53-year-old female, working as a tailor, was transferred to the orthopedic clinic after complaining of pain in her right plantar surface, and she was restricted from standing, walking, and descending stairs. The patient was administered analgesics and anti-inflammatory drugs, but the pain worsened. In the physical examination, there are no signs of trauma on the right foot. There was tenderness in the 2nd and 3rd metatarsal space, and increasing pain was obvious when the foot was squeezed. Magnetic Resonance Imaging (MRI) represents Neuroma in the intermetatarsal II-III segment. After a thorough examination, the patient was diagnosed with Morton Neuroma.
Clinical discussion
We performed a pulsed radio frequency (PRF) with linear Ultrasonography (USG) guidance from the plantar of the foot. PRF delivers in two cycles, each lasting 4 min. The patient was followed for six months. The Visual Analog Scale (VAS) and Foot and Ankle Disability Index (FADI) score were used to evaluate the patient's outcome.
Conclusion
A PRF approach is a favorable option for treating Morton's neuroma patients. VAS and FADI scores represent good functional outcomes.
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NewsBot · Jul 29, 2025

Combining Pulsed and Conventional Radiofrequency Ablation for Resistant Morton's Neuroma: A Case Report and Literature Review
Karim Hemati et al
Anesth Pain Med. 2025 May 19;15(3):e161482.

Introduction: 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.

Objective: 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.

Case presentation: 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.

Result: 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.

Conclusions: This case suggests that the combined application of PRF and CRF may serve as a promising alternative for managing refractory Morton's neuroma.
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NewsBot · Aug 14, 2025

Continuous Radiofrequency for Morton's Neuroma: Is There Complete Ablation? A Preliminary Report
Gabriel Camuñas-Nieves et al
Healthcare (Basel). 2025 Jul 28;13(15):1838.

Background and Objectives: Morton's neuroma is a painful foot condition that can be treated with continuous radiofrequency. However, its efficacy is not always optimal, with failure rates of 15-20%. It has been suggested that these failures may be due to incomplete nerve ablation, allowing for nerve regeneration and persistent pain. So, the aim of this study was to assess the histological effects of continuous radiofrequency on the nerves affected by Morton's neuroma. Materials and Methods: The effect of continuous radiofrequency was evaluated in two patients with Morton's neuroma, which required open surgery excision. In both cases, radiofrequency with a standard protocol was applied ex vivo, following the surgical excision of the neuroma. A TLG10 RF generator (90 °C, 90 s) with a monopolar needle with a 0.5 cm active tip was used. Subsequently, the samples were histologically analyzed to determine the degree of nerve ablation. Results: Histological analysis showed homogeneous focal necrosis in both cases, with lesion depths of 2.4 mm and 3.18 mm. However, areas of intact nerve tissue were identified at the periphery of the neuroma, suggesting incomplete ablation. Conclusions: The findings indicate that continuous radiofrequency does not guarantee total nerve ablation, which could explain recurrence in some cases. Intraoperative neurophysiological monitoring could be key to optimizing the procedure, ensuring complete interruption of nerve conduction and improving treatment efficacy
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NewsBot · Dec 20, 2025

The role of radiofrequency therapy in the treatment of Morton's neuroma: A case report
Romy Deviandri et al
Int J Surg Case Rep. 2025 Jun:131:111424.

Introduction and importance: Morton's Neuroma is a neuropathy of the forefoot, specifically located on the interdigital nerve, and is associated with the thickening of the intermetatarsal ligament and nerve fibrotic. The management of Morton's Neuroma is challenging. Various treatments have been introduced for treating this lesion, starting from conservative treatment using the metatarsal pad, physical therapy, and corticosteroid injection to surgical treatment. This report highlights a novel approach to Morton's Neuroma using a pulsed radiofrequency (PRF).

Case presentation: A 53-year-old female, working as a tailor, was transferred to the orthopedic clinic after complaining of pain in her right plantar surface, and she was restricted from standing, walking, and descending stairs. The patient was administered analgesics and anti-inflammatory drugs, but the pain worsened. In the physical examination, there are no signs of trauma on the right foot. There was tenderness in the 2nd and 3rd metatarsal space, and increasing pain was obvious when the foot was squeezed. Magnetic Resonance Imaging (MRI) represents Neuroma in the intermetatarsal II-III segment. After a thorough examination, the patient was diagnosed with Morton Neuroma.

Clinical discussion: We performed a pulsed radio frequency (PRF) with linear Ultrasonography (USG) guidance from the plantar of the foot. PRF delivers in two cycles, each lasting 4 min. The patient was followed for six months. The Visual Analog Scale (VAS) and Foot and Ankle Disability Index (FADI) score were used to evaluate the patient's outcome.

Conclusion: A PRF approach is a favorable option for treating Morton's neuroma patients. VAS and FADI scores represent good functional outcomes.
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NewsBot · May 10, 2026

Radiofrequency neurolysis versus surgical neurectomy for Morton’s Neuroma
Javier Adán-Laguna, Laura Villarroya Martínez, Germán Puyuelo Martínez, Juan Segura-Nuez, Carlos Pindado García, Carlos Martín-Hernández & Laura Ezquerra Herrando
International Orthopaedics

Morton’s neuroma is one of the most common forefoot pathologies. In recent years, radiofrequency ablation has emerged as a minimally invasive alternative to surgical excision, aiming to relieve symptoms while reducing morbidity.
Purpose

To compare the efficacy and safety of radiofrequency neurolysis and surgical excision for the treatment of Morton’s neuroma at our institution.
Methods

A single-center, observational, retrospective, and longitudinal study was conducted including patients treated between 2012 and 2022. Clinical data from patients who underwent either surgical excision or radiofrequency ablation were analyzed. Demographic characteristics, pain intensity assessed using the Visual Analog Scale (VAS), complication rates, and reintervention rates were recorded, with a minimum follow-up of two years. Statistical analysis was performed using SPSS version 25.
Results

A total of 192 procedures were identified (110 surgical excisions and 82 radiofrequency ablations). For analyses focused on demographic and baseline characteristics, repeated procedures performed in the same patient were grouped, resulting in 144 unique cases (92 excisions and 52 radiofrequency ablations). Both techniques resulted in significant pain reduction. Surgical excision achieved greater VAS improvement (− 5.57) compared with radiofrequency ablation (− 4.3). Complications were more frequent after surgical excision (13%) than after radiofrequency ablation (3.7%). In the radiofrequency group, 26% of patients required subsequent surgical excision and 33% underwent repeat ablation. The use of radiofrequency increased from 20% during 2012–2017 to 57% during 2018–2022.
Conclusions

Radiofrequency ablation is a safe and effective treatment for Morton’s neuroma, although its analgesic effect appears less durable than surgical excision. Its low complication rate and outpatient applicability make it a valuable alternative, particularly in selected patients.
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NewsBot · May 20, 2026

Effectiveness and safety of pulsed versus thermal radiofrequency in the treatment of Morton's disease
J. de Nicolás Gutiérrez et al
Source

Objective
To compare the effectiveness and safety of pulsed radiofrequency (PRF) versus thermal radiofrequency (TRF) in treating patients with Morton's neuroma (MN).
Patients
Twelve patients diagnosed with symptomatic Morton's neuroma unresponsive to conservative management, randomized into two equal groups (TRF vs PRF).
Materials and methods
All patients underwent ultrasound-guided radiofrequency treatment. The TRF group received continuous radiofrequency at 82 °C (2 × 45 s), and the PRF group received pulsed radiofrequency at 42 °C for 300 s. Pain (VAS), function (MOXFQ), walking/footwear limitations, satisfaction, and adverse effects were assessed at 3 weeks, 2 months, and 1year post-treatment.
Results
Both TRF and PRF significantly reduced pain and improved function. TRF showed superior improvement at 3 weeks (VAS p = 0.013 and MOXFQ p = 0.019), but no significant differences were found at 1 year. Both techniques were equally safe, with no adverse events. Patient satisfaction was slightly higher in the PRF group.
Conclusion
We present unprecedented results in current scientific evidence. TRF and PRF are both effective and safe options for treating Morton's neuroma. TRF provides earlier and greater relief, while PRF offers a more comfortable alternative. Further research with larger sample sizes is needed to confirm these findings.
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Radiofrequency Ablation for the Management of Morton's Neuroma

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Radiofrequency Ablation for the Management of Morton's Neuroma

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Radiofrequency ablation in onychocryptosis

cryotherapy/radiofrequency ablation, sclerosing or PRP injection for neuroma?

Radiofrequency Microdebridement for Achilles Tendinosis

Pulsed radiofrequency stimulation of posterior tibial nerve for recalcitrant plantar fasciitis

Radiofrequency microtenotomy vs plantar fasciotomy for plantar fasciitis

Intra-articular Pulse-Dose Radiofrequency for Hallux Valgus Pain

Radiofrequency microtenotomy

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