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The Encinitas Podiatry Group is pleased to introduce foot cryosurgery, a new minimally-invasive procedure for the management of Plantar Fasciitis/Heel Spur Syndrome and Neuromas and certain other foot conditions. Cryosurgery is a near-painless and safe in-office procedure utilizing controlled cooling temperatures to eliminate painful conditions by freezing the nerves to the area of pain. Dr Hatfield is excited about this new technology and is hopeful it will become an enhancement in the treatment of his patients. We are the first foot surgeons in San Diego County to be certified to perform these procedures which destroy pathological tissue (sensory nerves that produce pain) via a cryoprobe.

Foot Cryosurgery Indications

  • Planar fasciitis/heel spur syndrome pain
  • Morton's neuroma

Advantages to Foot Cryosurgery

  • Painless under local anesthesia
  • 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 complication
  • May permit patient to ambulate barefoot where they could not previously.

Cryoanalgesia has been known to decrease pain and inflammation for centuries. Physicians, physical therapists and sports trainers have relied on ice therapy to address many musculoskeletal conditions and injuries in particular, during the early inflammatory phase. Not only do lowered temperatures result in vasoconstriction of blood vessels, thus reducing inflammation, but also create an anesthetic effect by altering nerve function. Historically, researchers performing cryosurgery observed that extreme freezing had an anesthetic effect beyond the temporary relief produced by simple cooling. Over the last thirty years, many modalities have been introduced to address chronic pain by surgeons, pain management specialists, and neurosurgeons. These techniques have had a common goal of producing prolonged nerve blocks to relieve intractable pain. Within the last ten years, cryosurgery has been utilized to relieve trigeminal nerve pain, lumbosacral pain and most recently carpal tunnel syndrome.

Principles of Cryoanalgesia

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. Cryoanalgesia, (also known as cryoneurolysis or cryoneuroablation) involves the destruction of the pathological nerve cell by freezing intracellular elements leading to nerve 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 scar tissue or neuroma formation.

       

The Cryosurgery Procedure

The cryosurgery procedure for foot problems is a very simple office procedure that lasts from 15 to 30 minutes. It is elegant in its simplicity and effectiveness. No special preparation is required prior to the procedure and afterwards patient's area able to walk and resume normal activities, other than sports, immediately Because of the numbing effect of the ice therapy, no special anesthesia is required (just local anesthesia block in the office) and as such, the procedure is comfortably performed in the office.

We perform the procedure in our minor surgery suite. First, the area of pain is mapped on the skin. The area is given local anesthesia and is prepared as in any other surgical procedure. A very small incision is made and the cryoprobe is introduced beneath the skin. The incision is so small that no sutures are required. The probe is brought to the location desired and confirmed with ultrasound image. The tissue within approximately an 8mm diameter is frozen. Two 3 minute freezing sessions are made with a 30 second thaw between. A light dressing is applied and the patient is immediately able to walk out. Post-operative pain medication is not usually prescribed.

It should also be noted that no treatment, including cryosurgery should be considered to be 100% successful. However, this approach does have a high success rate (approximately 80%) with very little potential for risk or side effects. Rarely, patients have a temporary increase in symptoms, similar to other surgical procedures. Additionally, on occasion the area of pain extends beyond the area of freeze so that a second cryosurgery treatment may be needed later.

Insurance Coverage

The cryosurgery procedure is not covered by most insurance companies, including Medicare.

More Information:

Plantar Fasciitis:

DISCLAIMER: *MATERIAL ON THIS SITE IS BEING PROVIDED FOR EDUCATIONAL AND INFORMATION PURPOSES AND IS NOT MEANT TO REPLACE THE DIAGNOSIS OR CARE PROVIDED BY YOUR OWN MEDICAL PROFESSIONAL. This information should not be used for diagnosing or treating a health problem or disease or prescribing any medication. Visit a health care professional to proceed with any treatment for a health problem.

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