Cashley David G, Cochrane Lynda
PhD Student, Department of Life Sciences, Queen Margaret University, Edinburgh, Scotland.
Doctor, Division of Population Health Sciences, Medical Research Institute, University of Dundee, Dundee, Scotland.
J Chiropr Med. 2015 Jun;14(2):90-8. doi: 10.1016/j.jcm.2015.04.003. Epub 2015 Jun 24.
The purpose of this retrospective case series is to describe treatment outcomes for patients with plantar digital neuralgia (PDN) (Morton's neuroma) who were treated using foot manipulation.
Charts were reviewed retrospectively for patients with a diagnosis of PDN and who received a minimum of 6 treatments consisting of manipulation alone. Visual analogue pain scales (VAS) and pressure threshold meter readings (PTM) were extracted as outcome measures.
Thirty-eight cases met inclusion criteria. Mean pretreatment duration of pain was 28 months. Mean pretreatment VAS was 69.5/100 mm. Mean pretreatment PTM was 2.54 Kp. By the sixth treatment, 30 (79%) of the 38 patients scored a VAS of 0 mm and a further 4 (10%) were below 10 mm. Contralateral limb PTM showed a mean pre-treatment score of 5.5 Kp, which rose slightly to 5.85 Kp. This compared to a pre-treatment score of 2.54 Kp rising to 5.86 Kp in the affected limb. This represents a 126% increase in the affected side compared to 6.5% in the unaffected limb. Statistical analysis demonstrated a significant linear trend between decreasing VAS and manipulation (P < .001).
The patients with PDN who were included in this case series improved with conservative care that included only foot manipulation.
本回顾性病例系列的目的是描述采用足部手法治疗的跖趾神经痛（PDN，莫顿神经瘤）患者的治疗结果。
对诊断为PDN且至少接受6次单纯手法治疗的患者病历进行回顾性分析。提取视觉模拟疼痛量表（VAS）和压力阈值计读数（PTM）作为疗效指标。
38例符合纳入标准。疼痛的平均预处理持续时间为28个月。预处理时VAS的平均值为69.5/100mm。预处理时PTM的平均值为2.54Kp。到第6次治疗时，38例患者中有30例（79%）的VAS评分为0mm，另有4例（10%）低于10mm。对侧肢体的PTM显示预处理时平均评分为5.5Kp，略有上升至5.85Kp。相比之下，患侧肢体的预处理评分为2.54Kp，上升至5.86Kp。患侧相比未受影响肢体增加了126%，而未受影响肢体增加了6.5%。统计分析表明VAS降低与手法治疗之间存在显著的线性趋势（P < 0.001）。
本病例系列中的PDN患者通过仅包括足部手法的保守治疗得到了改善。
