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

Abstract

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.