Treatments for Morton's neuroma.

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: BM: none known; BM is a podiatrist and manages people with Morton's neuroma. He authored a 2019 systematic review of non‐surgical interventions for Morton's neuroma. CT: none known; CT is a surgical podiatrist and manages people with Morton's neuroma. He is an author of an RCT funded by the Chief Scientist Office Scottish Government, which is relevant to this systematic review. CT resolved study inclusion, data extraction, risk of bias and GRADE appraisal disagreements except for the included study (Thomson 2013), which he co‐authored. JM: none known; JM is an orthopaedic surgeon who manages people with Morton's neuroma. MH: none known; MH is a podiatrist and manages people with Morton's neuroma. He co‐authored a 2019 systematic review of non‐surgical interventions for Morton's neuroma. RW: none known; RW is an academic biostatistician. He co‐authored a 2019 systematic review of non‐surgical interventions for Morton's neuroma. RW is a Cochrane editor who was not involved in the editorial process for this review. 5. J Am Podiatr Med Assoc. 2022 May-Jun;112(3):18-191. doi: 10.7547/18-191. Extracorporeal Shockwave Therapy for Foot and Ankle Disorders: A Systematic Review and Meta-Analysis. Nazim B Tengku Yusof T(1), Seow D(2), Vig KS(3). Author information: (1)*Hospital Kuala Lumpur, Malaysia. (2)†Royal College of Surgeons in Ireland, Dublin, Ireland. (3)‡Department of Orthopedic Surgery, Albany Medical Center, Albana, NY. BACKGROUND: Extracorporeal shockwave therapy (ESWT) was first introduced into clinical practice in 1982 and has been a beneficial inclusion to the noninvasive treatment option of numerous orthopaedic pathologies. However, clinical evidence of the use of ESWT for various foot and ankle disorders has been limited with a consensus on its efficacy yet available. Therefore, the purpose of this study is to systematically review the literature, to provide a critical evaluation and meta-analysis for the use of ESWT in foot and ankle disorders. METHODS: The PubMed and Embase databases were systematically reviewed and clinical studies that reported ESWT use for various foot and ankle disorders included. RESULTS: A total of 24 clinical studies that included 12 randomized controlled trials and 12 case series were identified. Analysis of the evidence has indicated that ESWT can help manage plantar fasciitis, calcaneal spur, Achilles tendinopathy and Morton's neuroma. Meta-analysis of the change in pre- to post-VAS overall scores for plantar fasciitis significantly favored ESWT compared to placebo/conservative treatment with a MD -3.10 (95% CI, -4.36 to -1.83; I2 = 68%; P < 0.00001). CONCLUSIONS: The current evidence has suggested that ESWT can provide symptomatic benefit to plantar fasciitis treatment, with minimal and unremarkable side effects. Overall, ESWT has been demonstrated to be a safe treatment option with a favorable complication profile. Further well-designed studies of ESWT for the treatment of calcaneal spurs, Achilles tendinopathy and Morton's neuroma are warranted to more soundly and safely support its current use. Future studies are suggested to investigate the optimization of ESWT treatment protocols. DOI: 10.7547/18-191