Current evidence on radiofrequency ablation for symptomatic interdigital (Morton's) neuroma raises no major safety concerns. The evidence on efficacy is limited in quantity and quality. Therefore, this procedure should only be used with special arrangements for clinical governance, consent and audit or research.
Clinicians wishing to do radiofrequency ablation for symptomatic Morton's neuroma should:
Inform the clinical governance leads in their NHS trusts.
Ensure that patients understand the uncertainty about the procedure's efficacy and provide them with clear written information. In addition, the use of NICE's information for the public is recommended.
Audit and review clinical outcomes of all patients having radiofrequency ablation for symptomatic Morton's neuroma (see section 6.1).
NICE encourages further research into radiofrequency ablation for symptomatic Morton's neuroma. Further research should include details of patient selection and previous treatments. Studies should compare the procedure against other non‑surgical treatments, such as steroid injections. Outcome measures should include pain relief, the duration of treatment effect, and the need for subsequent treatments.