Extracorporeal Shockwave Therapy in Patients with Morton's Neuroma

Seok, Hyun; Kim, Sang-Hyun; Lee, Seung Yeol; Park, Sung Won

doi:10.7547/14-131

Cited by 20 publications

(27 citation statements)

References 19 publications

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“…Studies took place in United Kingdom (6 studies) [2, 7, 22, 39, 40, 50], Italy (5 studies) [8, 20, 23, 53, 55], United States of America (4 studies) [4, 5, 19, 49], Australia [1, 10], South Korea [52, 54], Spain [6, 41] and Turkey [3, 9] (2 studies each) and South Africa [48] and France [51] (1 study each). Clinical settings represented were Hospital (9 studies) [3, 8, 9, 22, 39, 41, 50, 52, 54], University [2, 6, 19, 20, 23, 48, 56] and Radiology [1, 7, 10, 49, 51, 53, 55] (7 studies each), and Private Practice (2 studies) [4, 5]. The study types consisted of seven RCTs [3, 39–41, 48, 50, 52], and 18 pre/post case series [1, 2, 4–10, 19, 20, 22, 23, 49, 51, 53–55].…”

Section: Resultsmentioning

confidence: 99%

The effectiveness of non‐surgical interventions for common plantar digital compressive neuropathy (Morton's neuroma): a systematic review and meta‐analysis

Matthews

Hurn

Harding

et al. 2019

Journal of Foot and Ankle Research

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Background Morton’s neuroma (MN) is a compressive neuropathy of the common plantar digital nerve. It is a common compressive neuropathy often causing significant pain which limits footwear choices and weight bearing activities. This paper aims to review non-surgical interventions for MN, to evaluate the evidence base for the clinical management of MN. Methods Electronic biomedical databases (CINAHL, EMBASE, MEDLINE and Cochrane) were searched to January 2018 for studies evaluating the effectiveness of non-surgical interventions for Morton’s neuroma. Outcome measures of interest were treatment success rate (SR) (binary) and pain as measured using 100-point visual analogue scale (VAS) (continuous). Studies with and without control groups were included and were evaluated for methodological quality using the Downs and Black Quality Index. Results from randomised controlled trials (RCT) were compared between-groups, and case series were compared pre- versus post-treatment. Effect estimates are presented as odds ratios (OR) for binary data or mean differences (MD) for continuous data. Random effects models were used to pool effect estimates across studies where similar treatments were used. Heterogeneity was assessed using the I 2 statistic. Results A total of 25 studies met the inclusion criteria, seven RCTs and 18 pre/post case series. Eight different interventions were identified, with corticosteroid or sclerosing injections being the most often reported (seven studies each). Results from a meta-analysis of two RCTs found corticosteroid injection decreased pain more than control on VAS (WMD: -5.3, 95%CI: -7.5 to − 3.2). Other RCTs reported efficacy of: manipulation/mobilisation versus control (MD: -15.3, 95%CI: -29.6 to − 1.0); extracorporeal shockwave therapy versus control (MD: -5.9, 95%CI: -21.9 to 10.1). Treatment success was assessed for extracorporeal shockwave therapy versus control (OR: 0.3, 95%CI: 0.0 to 7.1); and corticosteroid injection vs footwear/padding (OR: 6.0, 95%CI: 1.9 to 19.2). Sclerosing and Botox injections, radiofrequency ablation and cryoneurolysis have been investigated by case series studies, however these were of limited methodological quality. Conclusions Corticosteroid injections and manipulation/mobilisation are the two interventions with the strongest evidence for pain reduction, however high-quality evidence for a gold standard intervention was not found. Although the evidence base is expanding, further high quality RCTs are needed. Electronic supplementary material The online version of this article (10.1186/s13047-019-0320-7) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

The effectiveness of non‐surgical interventions for common plantar digital compressive neuropathy (Morton's neuroma): a systematic review and meta‐analysis

Matthews

Hurn

Harding

et al. 2019

Journal of Foot and Ankle Research

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“…Treatment with alcohol injections, steroid injections, botulinum injections, and extracorporeal wave therapy may lead to partial relief of symptoms. [82][83][84][85] Surgical excision yields a good to excellent outcome in more than 70% of reported cases. 86,87 Lateral Femoral Cutaneous Nerve…”

Section: Treatmentmentioning

confidence: 99%

Common Entrapment Neuropathies

Malek

Salameh

2019

Semin Neurol

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Entrapment neuropathies are defined as compression of peripheral nerves due to known or unknown causes. The high incidence and variety of presentations require a comprehensive knowledge of these conditions, especially in neurology and orthopedic surgery clinical practices. Detailed knowledge of topographic anatomy, clinical manifestations, and appropriate use of electrophysiological studies with selective addition of neuromuscular ultrasonography are needed to establish an early and accurate diagnosis to advice patients and provide them with a comprehensive treatment plan. In this article, we discuss the most common forms of entrapment neuropathies in the upper and lower extremities.

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“…1 CONSORT flow diagram. ESWT, extracorporeal shockwave therapy; VAS, visual analogue scale; SF-36, 36-Item Short-Form Health Survey; SAS, Self-Rating Anxiety Scale; SDS, Self-Rating Depression Scale; PSQI, Pittsburgh Sleep Quality Index neuralgia, and diabetic foot ulcers [7][8][9][10][11]. However, no randomized controlled trials to date have confirmed the efficacy and safety of ESWT in patients with PHN or explored the potential mechanisms of action.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of the extracorporeal shockwave therapy in patients with postherpetic neuralgia: study protocol of a randomized controlled trial

Chen

Zhou

Sun

et al. 2020

Trials

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Background: Postherpetic neuralgia (PHN) is one of the most common types of chronic neuropathic pain, which seriously affects quality of the life because of pain severity and poor response to the currently available treatments. The main strategies for PHN management are medication and invasive interventional therapies; however, these approaches have many adverse effects, so it is important to find another effective and safe treatment for PHN. Methods: A single-center, single-blind randomized clinical trial will evaluate 98 study participants randomized in a 1:1 ratio into control and experimental groups. The control group will receive conventional treatment including medication therapy and invasive interventional therapy. The experimental group will receive extracorporeal shockwave therapy (ESWT) in addition to conventional therapy. The primary outcome is pain intensity assessed on a visual analogue scale (VAS); the secondary outcomes are the following: quality of life assessed by the 36-Item Short-Form Health Survey (SF-36), psychological state for anxiety and depression measured by the Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS), and sleep quality measured by the Pittsburgh Sleep Quality Index (PSQI). Assessors blinded to the randomization will collect data during the intervention period at baseline and weeks 1, 4, and 12. The plasma levels of tumor necrosis factor-α and interleukin-6 will be assessed before and after ESWT to explore the biochemical mechanisms of ESWT in the treatment of PHN. Discussion: This randomized controlled trial will evaluate the effectiveness and safety of ESWT in patients with PHN and thus will provide clinical evidence for its use in the management of PHN and explore the potential biochemical mechanisms of this treatment.

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Extracorporeal Shockwave Therapy in Patients with Morton's Neuroma

Abstract: These results suggest that ESWT may reduce pain in patients with Morton's neuroma.

Cited by 20 publications

References 19 publications

The effectiveness of non‐surgical interventions for common plantar digital compressive neuropathy (Morton's neuroma): a systematic review and meta‐analysis

The effectiveness of non‐surgical interventions for common plantar digital compressive neuropathy (Morton's neuroma): a systematic review and meta‐analysis

Common Entrapment Neuropathies

Efficacy and safety of the extracorporeal shockwave therapy in patients with postherpetic neuralgia: study protocol of a randomized controlled trial

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