Effectiveness and safety of pulsed versus thermal radiofrequency in the treatment of Morton's disease.

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 (2×45s), and the PRF group received pulsed radiofrequency at 42°C for 300s. 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.