Low Level Laser Therapy for Morton’s neuroma
Morton neuroma is a common foot condition that is caused by entrapment neuropathy of interdigital nerve(1).
What is Low Level Laser Therapy?
Low level laser therapy is a relatively new technology that is being used to manage the joint and connective tissue pain. Due to low intensity of light radiations, the technique is also referred to as ‘Cold Laser’ as opposed to hot laser that is mainly use in surgical practice to excise/ cut biological tissues.
Low level laser therapy is ideally used on tissues that are worn-off, damaged or injured. The primary aim of this therapy is to elicit a photobiological or photochemical reaction within the tissues to promote healing and tissue regeneration. It is theoretically believed that introducing cold laser therapy to the damaged area can reduce pain, ongoing inflammation and tissue edema that eventually facilitate free-range, pain-free motion as well as considerable reduction in muscle spasms.
How effective is low level laser therapy for Morton’s Neuroma?
Unfortunately, the efficacy and effectiveness of low level laser therapy in the management of Morton’s neuroma is not proven and theoretical at best. So far there has been no clinical studies to validate the efficacy of cold laser therapy for Morton’s neuroma management (or for the management of any other musculoskeletal condition). For example, study published in Dermatologic Surgery (2)investigated the effectiveness of low level laser therapy in wound healing. Researchers argued that high energy laser therapy (10–100 W) may help in improvement of healing processes as well as cellular regeneration, but low level laser offers no help.
In another study reported in the Australian Journal of Physiotherapy (3), in which investigators evaluated the findings of 88 randomized controlled trials, investigators concluded that the response to Low Level Laser Therapy is marginal and highly variable.
This is mainly because, unlike any other form of tissue damage or injury, Morton’s neuroma is an entrapment neuropathy that involves degeneration and fibrosis of interdigital nerve due to poor foot dynamics (such as inadequate choice of footwear, unhealthy lifestyle and gear choices etc.) The pathophysiology of Morton’s neuroma is highly complex and involves several types and layers of connective tissue. Therefore, it is more logical to opt for more sophisticated and practical treatment options like:
- Conservative therapy (this involves lifestyle modification, change of gear/ shoes, orthotics/ insoles).
- Ultrasound guided corticosteroid injections.
- Ultrasound guided Neurolytic Injections
- Ultrasound-guided radiofrequency ablation.
- Ultrasound guided Cryotherapy Ablation also referred to as Cryosurgery.
- Ultrasound guided Plasma Rich Platelet Injections
- Stem Cell Therapy
Speak to your doctor to learn what treatment options are best for you.
- Ha’Eri, G. B., Fornasier, V. L., & Schatzker, J. (1979). Morton’s neuroma-pathogenesis and ultrastructure. Clinical orthopaedics and related research, 141, 256-259.
- Posten, W., Wrone, D. A., Dover, J. S., Arndt, K. A., Silapunt, S., & Alam, M. (2005). Low‐level laser therapy for wound healing: mechanism and efficacy. Dermatologic surgery, 31(3), 334-340.
- Bjordal, J. M., Couppé, C., Chow, R. T., Tunér, J., & Ljunggren, E. A. (2003). A systematic review of low level laser therapy with location-specific doses for pain from chronic joint disorders. Australian Journal of Physiotherapy, 49(2), 107-116.
- Hopkins, J. T., McLoda, T. A., Seegmiller, J. G., & Baxter, G. D. (2004). Low-level laser therapy facilitates superficial wound healing in humans: a triple-blind, sham-controlled study. Journal of athletic training, 39(3), 223.
Janet D. Pearl, MD, MSc is the Medical Director of The Center for Morton’s Neuroma and Complete Spine and Pain Care, an interventional and integrated Pain Management program located in Framingham, Massachusetts. Previously, Dr. Pearl was the Co-Director of the Pain Management Center at St. Elizabeth’s Medical Center, where she was also the Director of the Fellowship program. She is the former Director of a satellite pain center of the Brigham and Women’s Hospital, Pain Management Center, located at the HealthSouth Braintree Rehabilitation Hospital. Dr. Pearl held academic appointments at Harvard Medical School and Tufts Medical School. She serves on the Health Care Services Board of the Commonwealth of Massachusetts Department of Industrial Accidents since 2000 as one of its physician representatives and is Chair of the Committee on Pain Management.