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Extracorporal Shock Wave Therapy (ESWT) for Morton’s Neuroma

Morton's neuroma shock wave treatmentWe use a type of ESWT called Extracorporeal Pulse Activation Technology or EPAT®  which has recently been shown to be quite effective when used in Morton’s neuroma. Extracorporeal Pulse Activation Technology uses high frequency sound waves that are directed at the neuroma  to promote healing.

The exact therapeutic mechanism of shock wave therapy still remains a topic of speculation despite extensive research. It is thought that sound waves damage tissues to induce microtrauma, which stimulates the healing process by attracting blood vessels and nutrients to the neuroma. The sound waves also inhibit pain receptors.

Usage in Morton’s neuroma: We use EPAT in conjunction with an ultrasound guided ablation for post Morton’s neuroma surgery patients and in certain patients with complex histories.  EPAT helps to break down scar tissue and promote blood vessel growth. We do not use EPAT as a primary course of treatment for Morton’s neuroma.

Side effects are rare especially when procedure is performed in expert hands. Side effects may include: bruising, post-procedure inflammation, discomfort, pain, swelling and tenderness (all of which usually resolve spontaneously.) Contraindications to EPAT include: a history of hemophilia or other coagulopathies; malignancy; and open bone growth plates (physes.)

Relief: EPAT has a cumulative effect so repeating the procedure can be beneficial. The full effect each treatment may take up to 6 weeks.


  1. Seok H, Kim SH, Lee SY, Park SW., Extracorporeal Shockwave Therapy in Patients with Morton’s Neuroma A Randomized, Placebo-Controlled Trial.; J Am Podiatr Med Assoc. 2016 Mar;106(2):93-9. doi: 10.7547/14-131; https://www.ncbi.nlm.nih.gov/pubmed/27031544
  2. Fridman R1, Cain JD, Weil L Jr., Extracorporeal shockwave therapy for interdigital neuroma: a randomized, placebo-controlled, double-blind trial.; J Am Podiatr Med Assoc. 2009 May-Jun;99(3):191-3; https://www.ncbi.nlm.nih.gov/pubmed/19448168

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