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Cryosurgery Procedures PDF Print E-mail

What is Cryosurgery?

The simplest way to describe what happens is to use the analogy of applying ice to an injury. One of the oldest treatments known to man is the application of ice to painful areas. This dates back to the time of Hippocrates who among his many accomplishments also wrote the first records detailing “ice therapy”. The application of ice serves two purposes. First it reduces swelling and inflammation to the site at which it is applied and secondly, it causes a mild “numbing” effect for as long as it is applied. In fact applying ice is often still the first line of treatment for minor injuries. Athletes will often soak their elbows in ice baths or wrap their knees and shoulders in ice after games to help reduce swelling and muscle soreness afterwards.

Now think of how effective this “ice therapy” could be if the ice could be applied directly to the area of most pain (under the skin where the damaged tissue and inflammation exist) instead of just on the surface of the skin. In essence applying a concentrated ice pack directly to the damaged and inflamed tissues involved. Better yet, how about applying this ice pack directly on the nerves responsible for transmitting the sensation of pain? Would direct numbing of the nerve stop the sensation of pain? Yes it can, and that's how cryosurgery helps relieve pain.

Cryosurgery Cryostar Technology

cryosurgeryThe Cryomed Corporation from England has developed the Cryostar. Over the past 10 years, its use for podiatric-related conditions has been extensively tested for safe, effective and proven pain relief. The Cryostar was FDA approved for use in podiatric ailments in June 2003. Since bringing this "state of the art technology" to the podiatric arena, only a select group of Cryostar Certified Podiatric Physicians are qualified and demonstrate the necessary expertise to treat these painful foot conditions.

1Foot 2Foot Centre for Foot and Ankle Care is the premier Cryosurgery Center for Feet in Hampton Roads. 1Foot 2Foot is one of only five certified Cryostar podiatrists in Virginia performing cryosurgery procedures on a regular basis. As the premier Podiatric Cyrosurgery Center in Hampton Roads, you will be assured of receiving expert care by the most experienced cyrosurgeon.

Principles of Cryoanalgesia (Nuts & Bolts)

Cryosurgery is a treatment modality that utilizes controlled cooling to destroy pathological tissues. Cooling is accomplished via the expansion of highly pressurized and compressed gas (nitrous oxide) through a cryoprobe. Cryoneurolysis involves the destruction of the pathological nerve cell by freezing intracellular elements leading to cell death. The surrounding soft tissue (epineurium, perineurium) of the nerve fiber remains intact allowing for subsequent nerve regeneration. This differentiates cryolesions from other neurolytic lesions that destroy the surrounding soft tissue that ultimately may result in neuroma formation.

Cryosurgery for Feet

Although cryosurgery has been used in medicine for years, it has just recently been introduced as an effective procedure for many painful foot problems. Recently FDA approved for podiatric use in June 2003, many patients have chosen cryosurgery as an effective alternative treatment to the traditional surgical methods of treating many chronically painful foot ailments.

Cryosurgery Procedure

The cryosurgery procedure for foot problems is a very simple office procedure that lasts from 15 minutes up to ½ hour. It is an elegant procedure in its simplicity and effectiveness. No special preparation is required prior to the procedure and afterwards patients are able to walk and resume normal activities usually within one day. Because of the numbing effect of the ice therapy, no special anesthesia is required (just a local anesthesia block in the office) and as such, the procedure is comfortably performed in the office.

Does it Work?

YES! Just like applying an ice pack on the skin relieves minor aches and pains, cryosurgery has been shown to be very effective in relieving very painful foot conditions such as heel pain (plantar fasciitis, heel spurs), neuromas, and has been showing promising results in treating other conditions such as tarsal tunnel pain, Achilles tendonitis and may even be helpful in cases of arthritis and diabetic neuropathy. Haven’t answered all your questions yet? Give us a call 757-934-0768 to schedule an appointment and we will be very happy to discuss the procedure with you.

Foot Cryosurgery Indications

  • Plantar fasciitis/heel spur syndrome
  • Morton's neuroma
  • Plantar fibroma
  • Neurofibroma
  • Allodynia and paresthesias
  • Advantages to Foot Cryosurgery
  • Painless
  • Minimally invasive
  • In-office procedure
  • Ambulatory the day of the procedure
  • Minimal to no downtime from work or activity
  • Bypass prolonged use of pain medications that may otherwise create other systemic complication
  • May prolong the necessity for custom-molded orthotics (shoe inserts)
  • May permit patient to return to fashion shoes, sandals and heels
  • May permit patient to ambulate barefoot

Dr. Dairman is one of only a small number of podiatric physicians in the country to now offer cryosurgery for foot problems. Although cryosurgery is a simple office visit for the patient, only a select group of podiatrists have the training and qualifications to perform the procedure.

Cryoneuroablation for Neuroma & Heel Pain

What is it?

Cryoanalgesia means pain relief from cold. When pain has been identified to be caused by nerves, one technique of offering long- term relief is to "freeze" the nerve. Under local anesthesia, performed in the office, a probe is placed under the skin on top of the nerve. A nerve stimulator is used to "hone in on the nerve" and you will feel a tingling or burning as the probe gets closer to the nerve. When the probe is in the exact right spot, the tip of the probe goes to a minus 70 degrees centigrade, forming an ice ball which kills the nerve but leaves the nerve insulation intact. This allows the nerve to grow back potentially without pain. If the pain does come back, there are no limits to the number of times the nerve can be refrozen.

The area burns for about 30 seconds during the freezing process and then gets numb. We ask that you bring a driver with you. The actual procedure takes 7 minutes, but you can expect to be in the office for a total of one hour. There is the risk of bleeding, bruising or infection any time you put a needle through the skin. Before the nerve is actually frozen, special care is used to insure that the probe is not too close to any muscle nerves. Areas where the skin is thin may also be at risk for "frostbite" is the ice ball is too close to the skin surface. This can cause skin damage resulting in scars or changes in skin color.

What happens after the treatment?

Occasionally, some patients complain of burning after the treatment. This not unusual. When you get home, apply ice to the area for 20 minute intervals for 3 hours. You may also experience some discomfort for a few days following the procedure. You may take pain medications prescribed by the doctor and apply ice as discussed above. There may be bruising along the nerve frozen. This is not uncommon and will fade as the area heals. It is important that you take it easy for approximately 2 days before returning to work. The procedure is usually performed on a Friday, allowing for the weekend to recover. You may return to work or activity on Monday.

What conditions is the procedure indicated for?

Cryoneuroablation has been used successfully for pain management for the past 15 years. In podiatric medicine, this technology has proved to be a safe and effective treatment for treating foot neuromas, heel pain and recalcitrant nerve pain.

Who is not a candidate for this procedure?

Patients who have a history of bleeding disorders or have local or systemic infections are not candidates for this procedure.

What are the advantages of foot cryosurgery?

  • Minimal discomfort
  • Long term pain relief
  • Low incidence of complications
  • High procedure success rate
  • Treatment may be repeated
  • No stump neuroma formation
  • Cost effective and covered by most insurance companies
  • Minimally invasive
  • In-office procedure
  • Ambulatory the day of the procedure
  • Minimal to no down time from work or activity
  • Bypass prolonged use of pain medications that may otherwise create other systemic problems
  • May prolong the necessity for orthotics
  • May permit the patient to return to fashion shoes or sandal