Cryosurgery is a specialised surgical technique using cryoanalgesia, or the application of extreme cold to tissues to obtain long term pain relief. It is a novel method that has been successfully applied to a number of podiatric conditions.

Introduction

The effectiveness of extreme cold for analgesia has been recognised for thousands of years. Hippocrates left us the first written records of the use of ice for pain relief. Modern Cryoanalgesia as we know it today was developed in the early 1960's. This technique is superior to other methods of peripheral nerve destruction (e.g. alcohol injections, phenol applications, or surgical resection) because it is not followed by neuritis or neuralgia.

There are few options for successful relief from painful foot conditions. Surgical resection of the nerves often leads to recurrent nerve growths called neuromas. These neuromas can be more painful than the original problem. Narcotics do not treat nerve pain but rather only "mask" the pain.

The application of cold to tissues creates a conduction block. This is similar to the effect of local anesthetics, but the effect is long lasting. Long-term pain relief from nerve freezing occurs because the formation of an ice crystal disrupts the sensory component of the nerve structure.

Cryostat Technology

The Cryostat was developed by Cryomed, in Nottingham ( www.cryomed.co.uk ). Over the past three years, its use for podiatric-related conditions has been extensively tested for safe, effective and proven pain relief. Since bringing this state of the art technology to the podiatric arena, only a select group of Cryostat Certified Podiatric Physicians are qualified and demonstrate the necessary expertise to treat these painful foot conditions. Mr Fellner was chosen to be one of these select few.

The Procedure

Mr.D. Fellner, Consultant Podiatric Surgeon, performs the cryosurgery. This minimally invasive technique takes around 15 minutes to perform. The painful area is infiltrated with a local anaesthetic, so that the cryoprobe can be introduced without discomfort. A tiny puncture is made through the skin. Next, a small blunt instrument called a trocar is placed through the puncture site to create a portal for the cryoprobe to be introduced. The probe is inserted through the puncture site and the Cryostar is set for a 3 minute freeze cycle, followed by a 30 second defrost, then another 3 minute freeze. The probe is then removed. An antibiotic ointment is placed over the puncture site with a sterile dressing applied. Sutures are not necessary due to the small size of the puncture. The dressing may be removed after 48 hours and a shower is then permitted. The puncture site is to be covered with a small amount of antiseptic ointment and a band-aid. It is suggested that you decrease your normal level of activity over the first 48 hours. There can be some discomfort afterwards and this will gradual improve. You can use regular painkillers e.g. Paracetamol and / or an ice pack to help with this, as necessary.

Indications for Cryosurgery

Plantar fasciitis

The most common ailments seen in podiatry practice are plantar fasciitis, heel spurs and generalized heel pain. Over the years many different treatments have been developed to try to eliminate these painful conditions. Cortisone injections, strappings, orthotics, and oral anti-inflammatories have had limited success. Even the newer surgical procedures such as endoscopic plantar fasciotomies, and ESWT (shock wave therapy) have not shown dramatic results. The Cryostat has been able to achieve results equal or better than these other surgical procedures, and at a much lower cost to YOU the patient.

Morton's neuromas

Morton's neuromas are another common podiatric condition. Symptoms present as pain commonly between the third and fourth and / or second and third metatarsals that causes numbness, tingling, burning, or shooting pains into the involved toes. Patients often experience the sensation of an electric shock in the ball of the foot. Pressure from ill-fitting shoes appears to exacerbate the symptoms. The term neuroma actually refers to a benign nerve tumour in the foot. Standard treatments such as cortisone injections and surgery have led to less than optimal results. The Cryostat is a more effective treatment option for these painful nerve conditions. It has also proven effective for patients who have undergone previous surgical treatment with recurrence of the nerve tumour.

Other indications

Insurance Cover

Private insurance plans may or may not offer help with this new treatment. We recommend that you speak to your insurance agent if you need to have financial support for this. It is your ultimate responsibility to check with your insurance carrier for specific coverage exclusions or limitations.

As with other treatments it is our normal policy to request advance payment, with or without health insurance. We will be happy to assist you with your health insurance claim.