For Patients
Radiofrequency Ablation (RFA) for Morton's Neuroma
Morton’s Neuroma is thickening and scarring that can involve the nerves in the forefoot. It typically causes pain on the balls of the feet, and often shooting pain in the toes. It may feel as though you are walking with a pebble in your sock.
Radiofrequency Ablation (RFA) involves inserting an electrode into the neuroma using ultrasound guidance. Then, using high frequency radiowaves, the electrode is heated to 85 degrees to destroy the neuroma.
RFA is a safe, effective and minimally invasive treatment for Morton’s neuroma.
Download our patient information sheet here.
Below you’ll find answers to the questions we’re asked the most:
Frequently Asked Questions
What is the referral process?
The referral process is easy, and providing certain criteria are met, you can be referred directly for the procedure.
- If your treating Health Professional is confident that you have a Morton’s Neuroma (you’ll need an ultrasound or MRI for this) AND that your pain is caused by it, you can be referred directly for the procedure. Please note that it is very important that your referral includes this information.
- If you haven’t had an ultrasound or MRI, or it is not certain that a Morton’s Neuroma is the cause of your pain, an initial consultation with Dr Bell will be required. This is a comprehensive evaluation, and includes a diagnostic ultrasound scan. Consultation fee for this is $500.
- Your procedure is then scheduled, and takes around an hour
Can I self-refer?
A referral from a Health Professional is required.
Health Insurance and ACC
Depending on your policy, many health insurers, including Southern Cross, cover the cost of the procedure. We recommend you check with your insurer. We can provide a quote for the procedure if pre-approval is required.
Morton’s Neuroma is not an injury, and so this treatment is not covered by ACC.
Preparation
You need to advise Dr Bell if you:
- Are taking any blood thinners (Aspirin is OK)
- Have any rash or skin problem affecting the skin around the affected toes
- Are diabetic
- Have a pacemaker or implantable defibrillator
- Have any allergies
The procedure
On the day:
- Ensure your foot is thoroughly cleaned with soap and water.
- Wear clean socks (open footwear is fine).
Your appointment will take approximately one hour.
Anaesthetic is injected to anaesthetise the nerves supplying the foot. You can expect your whole foot to feel numb for some hours after the procedure.
A cannula is then inserted into the neuroma, and an electrical current is passed through it for around 2 minutes. This creates heat at the tip, ablating the neuroma. The cannula is then repositioned 2 to 3 times, and the procedure repeated.
Once completed, a small dressing is applied. Comfortable footwear with a soft sole is recommended afterwards.
After the procedure
Because your foot will be numb for a few hours after the procedure, we advise against driving for the remainder of the day, and you will need to take care while walking (avoid uneven or irregular surfaces).
When the anaesthetic has worn off, most patients describe pain as a mild burning sensation. Use paracetamol or an anti-inflammatory as needed.
It is safe for you to travel home on the day of the procedure (including by air), however if you can, keep your foot elevated for the remainder of the day, applying ice for 20min each hour.
Wear comfortable shoes or sneakers for a week after the procedure, keeping the procedure area clean and dry.
Return to activity and exercise
You can return to light activity the next morning and can go to work as long as your job isn’t too strenuous (if you have a strenuous job, a week off is advised).
Limit walking and other activities that put pressure on your foot for the first 1-2 days. Day to day activities around the home are perfectly safe.
Gradually increase walking distance from day 3, as tolerated.
Avoid high-impact activities, especially those that put stress on the ball of your foot, for at least 2 -3 weeks.
Examples of return to exercise:
Week 1: Gradually increase walking distance from day 3. After a week, you should be able to manage 30min without too much discomfort. Upper body gym workouts are fine, as well as light cycling.
Week 2: Longer walks are fine as tolerated, as well as cycling and moderate gym workouts
Week 3: You can start to jog, initially 10 minutes, increasing as tolerated.
Week 4: Most people can return to a normal level of activity. Be guided by discomfort at the procedure site.
When will I notice a difference?
Many patients notice a difference within 1-2 weeks, however this does vary, and we normally advise that the final outcome will take up to two months.
What are the risks?
RFA for Morton’s Neuroma is safe and effective. Research suggests that the risk of complications is very low. Risks include:
- Infection at the procedure site
- Bruising or haematoma formation
- Thermal burn to skin (very rare)
- Nerve damage causing pain (very rare)
- Procedure failure – occasionally a repeat procedure is required
Additionally, the nerve that is ablated supplies sensation to a small section of skin between the toes, and so you will be left with numbness in this region. You may not notice this.